Factors influencing the operative results of displaced intra-articular calcaneal fracture

Abstract

Objective To determine the factors influencing the results of open reduction and internal fixation for displaced intra-articular calcaneal fracture (DIACF). Methods From May 2009 to June 2013, 80 patients with DIACF involving in 91 feet were treated by open reduction and internal fixation. Mean age was 38.7 years (range, 18-72 years). Patients were grouped according to the possible factors related to the operative results, including the Sanders classification of fracture, quality of fracture reduction, postoperative Bohler angle, width of postoperative calcaneus, and time to surgery after injury. Clinical result was evaluated and compared within each group. Results Mean duration of follow-up was 18.3 months (range, 14-26 months). The clinical results were excellent for 67 feet (74%), good for 12 feet (13%), fair for 7 feet (8%) and poor for 5 feet (5%), which yielded 87% good to excellent results. Good to excellent results in Sanders Ⅱ, Ⅲ and Ⅳ groups reached 94%, 85% and 53% respectively, in quality of fracture reduction≤2 mm and >2 mm groups reached 93% and 30% respectively, in postoperative Bohler angle 14 days groups reached 91% and 43% respectively, in age ≤60 years old and >60 years old groups reached 85% and 88% respectively. Except for the age group, the clinical result differed significantly within group (P<0.05). Conclusions Fracture type, reduction quality, postoperative Bohler angle, width of postoperative calcaneus, time to surgery after injury are the factors influencing on the operative results of patients with displaced intra-articular calcaneal fracture. Thereupon the unfavorable influences should be avoided to improve the operative results. Key words: Calcaneus; Fractures, bone; Treatment outcome; Influential factors