Functional and radiological outcome of depressed intra-articular fractures of calcaneus managed with operative methods

Abstract

Calcaneal fractures are the most common fracture of the tarsal bones, controversy still exists on the best treatment option for these fractures. However as a better understanding of fracture patterns with computed tomography scans and modern surgical techniques and hardware has improved outcome and lowered morbidity. Hence we aim at evaluating the radiological and functional outcomes of displaced intra-articular calcaneal fractures treated with operative methods with calcaneal plate or by percutaneous/mini-open Ilizarov fixation. In our study we included 30 patients, 23 were male and rest 7 were female. The mechanism of injury involved fall from height in 20 cases and road traffic accident in the remaining cases. These patients were followed average 14.6 months and the functional outcome was assessed in all the patients using Creighton-Nebraska health foundation assessment scale (CNHFAS). According to this scale, 8(26.66%) patients had excellent results, 14 (46.66%) patients had good results, 4(13.33%) patients had fair results and 4(13.33%) patients had poor results. The results were promising, revealing that the operative treatment of intra-articular calcaneal fractures should be done as anatomical reduction and rigid internal fixation to allow early movement and weight bearing. The technique of contoured plate fixation with a lateral approach and ilizarov external fixator are good with regards to fracture union and functional outcome.