Functional outcome in non-operative management of displaced Intra-articular calcaneal fractures (Diacf’s)

Abstract

Displaced intra-Articular calcaneus fractures (DIACFs) represent a source of potential disability to the patient, economic burden to the society and a treatment challenge to the average orthopedic surgeon. Despite lack of evidence whether operative management is superior to non-operative management, there is a trend favoring the former. This was a 2 year retrospective study & a 1 year prospective study of 37 patients with 44 displaced intra-articular calcaneal fractures managed non-operatively to observe the functional outcome of intra-articular fractures of calcaneus in adults in an Indian population. Each patient was followed up at 3, 6, 9 months and 1 year from injury. Appropriate lateral and axial view x-rays done at 3 months and 1 year follow-ups and radiological assessment done. Retrospective patients from previous two years were re-assessed with appropriate x-rays and functional outcome scoring done. The AOFAS score was assessed and recorded at each of these follow-ups. In our study of 37 patients with 44 displaced intra-articular calcaneal fractures, AOFAS clinical outcome at 1 year was excellent in 7 cases (15.91%), good in 29 cases (65.91%), fair in 7 cases (15.91%) and poor in one case (2.27%). Complications were seen in 11 patients at one year follow-up but none of the patients with complications required any surgical intervention and the average AOFAS functional outcome score at 1 year was 80.43 (Good). We hereby conclude that non-operative management of intra-articular calcaneal fractures continues to be an acceptable mode of treatment with low complications and comparable functional outcome with less complications.