Study of Functional Outcome in Calcaneal Fractures

Abstract

Background: 75% of calcaneal fractures are intra articular. Treating calcaneal fractures is a challenge for orthopaedic surgeon due to the complex fracture pathology. A wide range of treatment options varying from non operative to operative methods are available. The purpose of this study is to assess the functional outcome of conservatively treated and operatively managed intra articular calcaneal fractures. Methods: 25 intra articular fractures have been classified as per Computerized Tomography based Sanders system.11 fractures were treated conservatively.11 fractures were treated with open reduction and internal fixation with bone grafting and plating. 3 fractures were treated with percutaneous screw fixation. Functional outcome was assessed using Modified Rowe score after following the cases over mean period of 24 months. Results: In conservatively managed 11 fractures, average functional outcome score was good in 6 Sanders Type-I fractures, average functional outcome score was satisfactory in 3 Sanders Type –II fractures and was poor in 2 Type-III Sanders fractures. In percutaneously fixed 3 cases of Sanders Type –II intra articular fractures by screws, average functional outcome score was good. In fractures fixed with open reduction and internal fixation with bone grafting and plating, average functional outcome score was excellent in 6 Sanders Type-II fractures and good in 5 Sanders Type-III fractures. Conclusion: Sanders Type-I fractures can be treated conservatively with good functional outcome. Managing Sanders Type II and III conservatively results in satisfactory to poor outcome. Hence for Sanders Type-II and Type-III, Open reduction and internal fixation with plating and bone grafting has to be considered for achieving excellent functional outcome. Percutaneous screw fixation can also be considered which yields good functional outcome and less post operative complications.