Study of functional outcome of displaced intra-articular fractures of the calcaneum treated with open reduction, bone grafting, and plate fixation

Abstract

BACKGROUND: Calcaneal fractures are one of the most difficult and challenging fractures to treat by the orthopedic surgeon. Most of these fractures (i.e., almost 75%) are intra-articular. Furthermore, majority of these fractures are highly comminuted. Hence, open reduction and internal fixation (ORIF) with anatomical plate gives the best possible opportunity to bring about near-anatomical joint surface reduction and prevention of subsequent arthritis. This article studies the functional outcome after ORIF of such fractures. METHODS: Thirty patients, having intra-articular displaced calcaneum fractures, were admitted and included in the study after obtaining valid consent and permission from the ethical committee. All the patients were investigated with X-ray and computed tomography scan and classified according to the Sanders classification system. The functional outcome after surgery was measured using the American Orthopaedic Foot and Ankle Society (AOFAS) score. RESULTS: All patients had joint depression-type fractures with a similar history of trauma due to fall from height. Out of the 30 patients, 26 were male and 4 were female. After surgery, 20 patients out of 30 had good results with a mean AOFAS score of 82.6, 7 patients had fair results with a mean AOFAS score of 70.4, while the remaining 3 patients had poor results with a mean score of 50. Postoperatively, wound complications were seen in 2 patients which settled after debridement and medications. No other complication was encountered. CONCLUSION: Open reduction and rigid internal fixation of calcaneum fractures allows anatomical reduction of fracture, restoration of joint surface, and prevention of subtalar joint arthritis and helps in early mobilization after surgery.