Arthroscopic-assisted management of talus and calcaneus fractures: A narrative review of the clinical outcomes and surgical technique.

Abstract

While distinct in incidence and presentation, both talus and calcaneus fractures share a common challenge in their complex anatomy and high-energy mechanisms resulting in difficulties in treatment. With traditional open reduction and internal fixation (ORIF), these fractures carry a high risk of complications, such as avascular necrosis, infection and post-traumatic arthritis. New minimally invasive strategies have risen to the forefront, with arthroscopic-assisted reduction and internal fixation (ARIF) emerging as a promising alternative. This technique offers the potential for enhanced visualisation, reduced soft-tissue disruption, quicker recover and greater reduction advantage. The purpose of this narrative review was to discuss outcomes and surgical techniques of arthroscopic-assisted reduction and internal fixation (ARIF) of talus and calcaneus fractures. ARIF techniques varied in patient positioning, portal use and fixation strategies, but consistently emphasised anatomic reduction via microscopic visualisation typically with temporary Kirshner wires, followed by fixation with cannulated screws. Despite the technical learning curve, the use of ARIF demonstrated clear advantages in minimising soft-tissue trauma and enhancing joint preservation in both talus and calcaneus fractures. This review supports the growing role of minimally invasive techniques as a viable alternative to ORIF in patients with high-energy talus and calcaneus fractures. Level IV.