Open reduction and internal fixation of displaced intra-articular fractures of the calcaneus

Abstract

To evaluate the results of intra-articular calcaneal fractures treated with open reduction and internal fixation. Thirty-five displaced intra-articular calcaneal fractures in 34 patients were treated with open reduction and internal fixation from August 2001 to April 2003. Fracture classification was based on Sanders classification. Extended lateral approach, and fixed the fractures with AO titanium plate for calcaneus were performed. Bone graft was used in selected patients. Thirty-five fractures in thirty-four patients were evaluated using radiographic examinations and ankle hindfoot clinical rating system of the American Orthopaedic Foot and Ankle Society (AOFAS). Average follow-up was 18.3 months (range from 12 to 32 months). There were 30 type II fractures and 5 type III fractures. Average Böhler's angle was 5.6 degrees preoperatively and 28.2 degrees finally. Roentgenographic evaluation of calcaneal body dimensions showed restoration of heel height (97.7%) to virtually normal. Anatomic or near anatomic reductions were obtained in 80% of the cases. The average score was 88.1 for type II fractures, and 78.8 for type III fractures. Excellent or good clinical results occurred in 82.8% type II fractures, and 60.0% type III fractures. The overall excellent or good rate was 79.4%. From the results, open reduction and internal fixation for Sanders type II and type III fractures are recommended.