Clinical radiological and functional outcome of calcaneal fractures undergoing fixation with contoured locking plate

Abstract

Objectives: With the advancement in surgical technique and newer fixation devices the treatment outcome of calcaneal fractures have improved. Therefore it is paramount to identify the appropriate treatment techniques for better functional outcomes in terms of better stability and early weight bearing without pain. Hence this study was carried out to study the functional outcomes of displaced Intra-articular Calcaneal fractures, treated with operative management using contoured locking plate. Material and Methods: This study was carried out as a prospective study. Fifty (50 fractures) patients with acute, displaced Intra-Articular fractures of calcaneum aged above 18 years, were enrolled in the study. Open fractures and fractures older than two weeks were excluded. The functional outcome was measured by the “American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot scoring system” at twelve months. Results: Of the 50 patients, all were males. Five patients had bilateral fractures. 35 patients had left sided fractures, while 15 had right sided fractures and mode of injury for all the patients was fall from height. Post operatively all 50 patients had swelling, 20 patients had persisting pain, 5 had superficial infections and 2 had deep infection. Superficial infections healed with antibiotics and dressings, while the patient with deep infection had persistent pain and difficulty in walking with discharge from surgical wound site. Both of them underwent implant removal and debridement after a year. Of the 50, 32 had good results, 14 had fair results and 4 had poor results. Hence we conclude from the above findings that contoured plate fixation helps in improving the functional outcome of the patients in view of their physical and radiological findings. Conclusion: A relatively better functional outcome was observed in displaced and comminuted fractures in plating, provided that the Bohler's angle was restored. The technique of contoured plate fixation with a lateral approach is good with regards to fracture union and functional outcome.