Management of closed displaced intra-articular calcaneal fractures: Closed reduction & percutaneous screw fixation versus below knee cast application

Abstract

Introduction: Calcaneum is the most commonly fractured tarsal bone. Most calcaneal fractures are intra-articular and mostly associated with poor outcomes. The treatment of these fractures is still controversial. This study aims at guiding us to take appropriate treatment decisions in the management of closed displaced intra-articular calcaneal fractures. Materials and Methods: This prospective randomized comparative study was carried out over a period of 12 months in a sample size of 20 patients at Rajendra Institute of Medical Sciences (RIMS), Ranchi. 10 patients were treated by closed reduction and percutaneous screw fixation (Group A) and 10 by below knee cast application (Group B). Patients were followed up for 6 months and functional and radiological outcomes were compared. Results: The AOFAS score, VAS score and complication rates between the two groups were comparable. All fractures in both the groups united at 3 months follow up. There was better restoration of Bohler angle, calcaneal height and calcaneal width in operative group as compared to cast group at 6 months follow up. Conclusion: The present study shows that although the operative group was associated with better radiological outcomes, however the functional outcomes between the two groups were comparable.