A minimally-invasive procedure using percutaneous reduction and external fixation can be carried out for Sanders’ type II, III and IV fractures of the os calcis. We have treated 54 consecutive closed displaced fractures of the calcaneum involving the articular surface in 52 patients with the Orthofix Calcaneal Mini-Fixator. Patients were followed up for a mean of 49 months (27 to 94) and assessed clinically with the Maryland Foot Score and radiologically with radiographs and CT scans, evaluated according to the Score Analysis of Verona. The clinical results at follow-up were excellent or good in 49 cases (90.7%), fair in two (3.7%) and poor in three (5.6%). The mean pre-operative Böhler’s angle was 6.98° (5.95° to 19.86°), whereas after surgery the mean value was 21.94° (12.58° to 31.30°) (p < 0.01). Excellent results on CT scanning were demonstrated in 24 cases (44.4%), good in 25 (46.3%), fair in three (5.6%) and poor in two (3.7%). Transient local osteoporosis was observed in ten patients (18.5%), superficial pin track infection in three (5.6%), and three patients (5.6%) showed thalamic displacement following unadvised early weight-bearing.

The clinical results appear to be comparable with those obtainable with open reduction and internal fixation, with the advantages of reduced risk using a minimally-invasive technique.

Aims: The purpose of the study is to review retrospectively a series of consecutive unstable closed fractures of the humerus in order to evaluate clinical results. Methods: 40 patients affected by closed diaphyseal fractures of the humerus have been treated by Dynamic Axial Fixator (DAF Orthofix). Minimum follow up is two years. Only unstable fractures has been included in the protocol of treatment. Patients affected by uncontrolled diabetes, HIV and psychotic diseases have been excluded. Results were evaluated considering healing time, complications (number and quality), long term clinical results including back to work activity, functional findings and radiographic aspects. Results: Average time of healing is between 10 and 14 weeks. Results were: Excellent: 35; Good: 2; Fair: 2; Poor: 1. Complications were: non-union: 1; replacement of screws: 1; osteolysis of pin track: 4; realignments due to secondary displacement: 3; refracture after frame removal: 1. Conclusions: We believe that this semi-invasive, versatile and well tolerated method may be considered a valid alternative to conservative treatment or to internal synthesis even in case of single trauma, provided a careful selection of patients due to the necessity of close follow up during treatment time.