Outcome of Percutaneous Fixation of Calcaneal Fractures: A Prospective Analysis in an Indian Population

Abstract

Displaced intra-articular calcaneal fractures can be difficult to treat. Open surgical techniques are associated with wound complications, whereas nonoperative management leads to arthrosis. In the present study, 23 displaced intra-articular calcaneal fractures in 19 patients were treated with closed reduction and percutaneous Kirschner wire fixation. Sanders and Essex-Lopresti classification systems were used. We studied anatomical (Gissane and Bohler angles and width of calcaneus) and functional (Maryland Foot Score and American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score) outcomes after 6, 18, and 26 months. Mechanism of injury, fluoroscopy use, time since injury, time delay to surgery, method of reduction, and number of Kirschner wires used were recorded. The mean participant age was 29.5 (17 to 46) years, mean delay to surgery was 7 (2 to 12) days, mean length of surgery was 61 (range 20 to 175) minutes, and mean fluoroscopy time was 115 (range 20 to 254) seconds. All patients were followed for a minimum of 26 months, and the mean duration of follow-up was 32.4 (26 to 36) months. There were 18 (78.26%) joint depression and 5 (21.74%) tongue-type fractures, whereas there were 2 (8.69%) Sanders type II, 13 (56.52%) Sanders type III, and 8 (34.78%) Sanders type IV fractures. The mean Maryland Foot Score and American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score at 6 months were 86.7 (81 to 92) and 84.2 (75 to 93), whereas at 26 months, the scores were 87.7 (82 to 93) and 85.1 (75 to 94), respectively. No pin site infections, cases of sural nerve dysfunction, or revision/additional surgery was experienced, and 17 (86.6%) patients were able to return to their original occupation at the end of 26 months.