Purpose: The purpose of this study was to investigate the results of the surgical treatment of intra-articular calcaneum fractures according to the Ilizarov method or in combination with mini open reduction.

Materials and Methods: In the period 1996–2003, 17 patients with 19 calcaneal fractures (14 men and 3 women) were surgically treated by the Ilizarov method. 2 patients had calcaneum fractures on both sides. 15 fractures were caused by fall, whereas 4 of them by car accident. Fractures were classified according to the Saunders CT classification: 12 fractures were type II, 5 type III and 2 type IV.

The device consisted of two rings applied at the distal tibia and a foot plate. The closed reduction of the calcaneum fracture was achieved with the use of a 1,8 mm pin in the posterior side of the calcaneum body, which improved the Bohler angle, along with the Gissane angle. In cases where necessary a short approach to the posterior subtalar joint was implemented for the reduction of the articular surface. The patients were encouraged to partially load their foot from the 1st postoperative day.

Results: Results were evaluated according to the Maryland Foot Score. 7 fractures gave excellent results, 10 gave very good results, 1 fracture good result and 1 poor result.

Conclusion: Traditional methods of open reduction and internal fixation of calcaneum fractures are usually a contraindication in cases of severe fractures and severe soft tissue damage. According to several authors the use of pins in the reduction of fractures is comparable to the open reduction.

From this study the Ilizarov method was found to be particularly safe and can be used in cases associated with severe soft tissue damage offering a quick surgical treatment.

Purpose: The purpose of this study is the analysis of the results of the surgical treatment of complex and displaced acetabular fractures.

Material: We have the results of thirty four comminuted acetabular fractures that were treated with open reduction and internal fixation. Most of them concerned fractures of both columns.

Method: Thirty two of the fractures were operated through one technique (Kocher-Langenbeck, ilioinguinal, expansive iliofemoral, or lateral by lifting the greater trochanter).The other two were operated with a double procedure (Kocher-Langenbeck and ilioinguinal). For the internal fixation reconstruction plates were used together with free screws and sometimes hook like wires.

Results: Anatomic reduction was performed in 24 cases. The result was graded as excellent in 42%, good in 34%, fair in 16%, and poor in 8% of the cases. Posttraumatic arthritis was seen in cases were anatomic reduction was not possible and the level of the arthritis was in absolute relationship with the quality of the reduction. In cases were the reduction was anatomic, posttraumatic arthritis was rare. The clinical results were in absolute relationship with the quality of the reduction and they were satisfactory as soon as the relationship of the weight bearing surface of the acetebulum and the femoral head is regular. Avascular necrosis of the femoral head was seen in two cases.

Conclusion: The anatomic reduction of displaced complex acetebular fractures prevents posttraumatic arthritis and ensures satisfactory clinical results. The aim of the operation must always be the anatomic reduction of the acetabular cup and the bone structures around it. When this is not technically possible we have to try for the restoration of the relationship between the femoral head and the acetabular roof.