Letournel describes his operative philosophy and step-by-step technique for ORIF of displaced intraarticular calcaneal fractures, reporting functional outcomes in 99 cases with ≥2-year follow-up. The central question: what surgical principles are required to reliably restore subtalar joint function after complex calcaneal fractures?
When planning calcaneal ORIF, Letournel's framework reminds you that reducing the thalamus alone is insufficient — you must restore the spatial relationship of all three poles (thalamus, tuberosity, anterior process) and both articular surfaces to have any chance at subtalar motion.
The tight correlation between reduction quality and outcome in this series means intraoperative CT or fluoroscopic confirmation of articular congruence is not optional.
Letournel describes his operative philosophy and step-by-step technique for ORIF of displaced intraarticular calcaneal fractures, reporting functional outcomes in 99 cases with ≥2-year follow-up. The central question: what surgical principles are required to reliably restore subtalar joint function after complex calcaneal fractures?
When planning calcaneal ORIF, Letournel's framework reminds you that reducing the thalamus alone is insufficient — you must restore the spatial relationship of all three poles (thalamus, tuberosity, anterior process) and both articular surfaces to have any chance at subtalar motion.
The tight correlation between reduction quality and outcome in this series means intraoperative CT or fluoroscopic confirmation of articular congruence is not optional.