Functional Outcome of Calcaneal Fractures Treated by Various Methods
Keywords:
Calcaneum, extra‑articular, intra‑articular, percutaneous surgeryAbstract
Introduction: Calcaneal fractures make up about 2% of all fractures. They account for 60% of major tarsal injuries. Anatomic restoration of the three‑dimensional anatomy of the calcaneum and restoration of weight‑bearing function is the goal of surgical management of calcaneal fractures. Over the years, various techniques have been developed to accomplish this goal. All these techniques have certain steps in common including disimpaction of the fragments, reduction of the displaced fragments either manually or percutaneously and protection of reduction with plaster pins and plaster, external fixation and open reduction and internal fixation. Materials and Methods: This is a retrospective study of 41 patients (50 fractures) with calcaneum fractures from 15 to 60 years of age, managed either conservatively or operated at our institution between 2012 and 2017, with regular detailed clinical and radiological follow‑up for minimum of 6 months. Results: In this series, we have used American Orthopaedic Foot and Ankle Society score for assessment of our result. Ninety‑three per cent fractures had good to excellent result in non‑operative group and 77% fracture had good to excellent result in the operative group. In intra‑articular fractures with joint depression pattern, 9 (69%) of the percutaneously fixed fractures had good to excellent results and 8 (66%) of the Open reduction and internal fixation (ORIF) group had good to excellent results. Eight (33%) with fair result had persistent heel widening and pain. One patient had loss of reduction, but all of them have returned to their original occupation. In intra‑articular fractures with Tongue type fracture, all 7 (100%) fractures had good to excellent results, whether they were fixed percutaneously or via open fixation. Conclusion: In this retrospective study, we observe that there was no significant difference noted, with respect to the functional outcome, between the operated and non‑operated group.
References
1. Slatis PK, Kiviluoto O, Santavirta S. Fractures of the calcaneum.J Trauma 1979;19:939‑44.
2. Aaron DA. Intraarticular fractures of the calcaneum. J Bone Joint Surg1974;56:567.
3. Fitzgibbons TC, Mcmullen ST, Mormino MA. Fractures and dislocationsof the calcaneus. In: Bucholz RW, Heckman JD, editors. Rockwood andGreen’s Fractures in Adults. 5th ed., Vol 2. Philadelphia: Lippincott,Williams and Wilkins; 2001. p. 2133‑56.
4. Sanders R. Intra‑articular fractures of the calcaneus: Present state of theart. J Orthop Trauma 1992;6:252‑65.
5. Nambiar MR, Umesh SN, Kamath KR. Percutaneous pin fixation ofcalcaneal fractures. J Orthop Assoc South Ind 2004;1:64‑7.
6. Buckley RE, Meek RN. Comparison of open versus closed reductionof intraarticular calcaneal fractures: A matched cohort in workmen. J Orthop Trauma 1992;6:216‑22.
7. Paley D, Hall H. Calcaneal fracture controversies can we put humptydumpty together again? Orthop Clin North Am 1989;20:665‑77.
8. Pozo JL, Kirwan EO, Jackson AM. The long‑term results of conservativemanagement of severely displaced fractures of the calcaneus. J BoneJoint Surg Br 1984;66:386‑90.
9. Hammesfahr R, Fleming LL. Calcaneal fractures: A good prognosis.Foot Ankle 1981;2:161‑71.
10. Wilson DW. Functional capacity following fractures of the os calcis. Can Med Assoc J 1966;95:908‑11.
11. Hildebrand KA, Buckley RE, Mohtadi NG, Faris P. Functional outcomemeasures after displaced intra‑articular calcaneal fractures. J Bone JointSurg Br 1996;78:119‑23.
12. Buckley R, Tough S, McCormack R, Pate G, Leighton R, Petrie D,et al. Operative compared with nonoperative treatment of displacedintra‑articular calcaneal fractures: A prospective, randomized, controlledmulticenter trial. J Bone Joint Surg Am 2002;84:1733‑44.
13. Essex‑Lopresti P. Results of reduction in fractures of the calcaneum. J Bone Joint Surg 1951;33:284.
14. Essex‑Lopresti P. The mechanism, reduction technique, and results infractures of the os calcis. Br J Surg 1952;39:395‑419.
15. Ibrahim T, Rowsell M, Rennie W, Brown AR, Taylor GJ, Gregg PJ. Displaced intra‑articular calcaneal fractures: 15‑year follow‑up of arandomised controlled trial of conservative versus operative treatment.Injury 2007;38:848‑55.
16. Leung KS, Yuen KM, Chan WS. Operative treatment of displacedintra‑articular fractures of the calcaneum: medium‑term results. J BoneJoint Surg 1993;75‑B:196‑201.
17. O’Farrell DA, O’Byrne JM, McCabe JP, Stephens MM. Fractures of theos calcis: Improved results with internal fixation. Injury 1993;24:263‑5.
Downloads
Published
Issue
Section
License
Copyright (c) 2019 Vatsal Vishnu, Ishani Patel, Dhaval R. Modi, Naitik Panchal, Nishant Bhavsar, Arpit Joshi (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors publishing in the Nigerian Journal of Orthopaedics and Trauma retain the copyright to their work.
All articles are published under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
