Objective: to study the surgical applicability and clinical results of the Vira^® system in treatment for severe fractures of the calcaneus.

Material and Method: 50 acute intraarticular fractures of the calcaneus treated with the Vira^® system over a two-year period were analyzed in 42 patients. The mean age was 41 years. Eight were bilateral fractures and 47 were closed fractures. According to the Sanders classification, most of the fractures were type IV, followed by type III AB, and the inferior cortical was broken in 42 cases. All the patients were evaluated, in a prospective manner, using the AOFAS scale, plain radiographs and CT scan studies.

Results: the average AOFAS score 12 months after surgery was 76.6 points (SD: 13.9). In 26% cases the results were very good, in 62% good, and in 12% mild and poor. The Böhler angle improvement after surgery was significant (p=0.05) though clinically irrelevant. Subtalar arthrodesis was achieved in all but two cases. The post-surgical complications were: 4 disorders of the plantar support, 4 cases of osteolysis at the tip of the screws, and 3 soft tissue problems.

Conclusions: The Vira system is a validated option for the surgical treatment of severe fractures of the calcaneus, yielding good clinical and radiological results with a surgical procedure that is only minimally aggressive and has a low rate of complications.

Introduction and purpose: When treating for loss of mobility in the elbow, after at least six months of conservative treatment following an injury we should consider surgery. The purpose of this study is to evaluate the improvement in range of motion after surgery.

Materials and methods: We reviewed the cases of elbow arthrolysis carried out in our hospital from 1999 to 2004, analysing the following variables: personal data (sex, age, type of work) and information on the injury (type, location, associated lesions and degree of stiffness). The main variables were degree of mobility in flexion/extension (F-E) and pronation/supination (P-S) before and after surgery, in addition to functional and occupational results.

Statistical analysis: Percentage estimate and by 95% confidence intervals, and analysis of increased mobility after surgery in F-E and P-S using Student’s t-test of repeated measures.

Results: 52 patients who underwent arthrolysis (86% males, mean age 37.2 years) whose jobs required average exercise and with grade II stiffness in 46.2% of the cases. The average preoperative ranges of motion for F-E and P-S were 74.52 (SD 32.3) and 120.10 (SD 66.6) degrees, respectively. The postoperative estimates for both parameters were 96.5 (SD 29.5) for F-E and 158.9 (SD 39.8) for P-S. The increases were statistically significant (p< 0.00001). The increased motion in P-S was slightly better than for F-E (p=0.054).

Conclusions: After our study, we can confirm that arthrolysis is an effective surgical procedure to improve mobility in stiff elbows. It is indicated when the joint interline is preserved. The lateral approach is the most common because it enables access to the anterior and posterior aspects of the capsule. Good functional and occupational outcome in a high percentage of cases.