Studying functional and radiological outcome of calcaneum fracture fixation using operative and nonoperative techniques in treatment of calcaneal fractures

Abstract

Abstract Backgroun: Management of Calcaneum fractures includes non-operative and operative management. Their has been various controversies regarding the same . With this study we have tried to gather the results of operative and non- operative management. Method: We conducted a prospective study for a period of 1.5 years to compare operative and nonoperative techniques in the treatment of calcaneal fractures. Patients attending the casualty, outpatient department (OPD), and those who were admitted indoors of SVBP hospital associated with LLRM Medical College and were assigned into two groups based on the treatment given operative and nonoperative treatment from April 2021 to October 2022 and were regularly followed for a period of 1.5 years .Radiological evaluation and functional assessment were done at 6 months and 1 year. The Functional outcome measures were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) scale and radiological parameters by means of Bohler’s and Gissane’s angles. Results: Forty patients with calcaneal fractures participated in our study. Twenty of them were operated, and 20 patients were treated conservatively with pop cast. Amongst operated cases, radiological Bohler’s angle was restored in 12 cases, and had good functional results at 1 year follow-up, and six cases showed fair results, whereas two patients had poor results (mean Bohler: 20.7; AOFAS: 70.8). Amongst the Twenty cases treated conservatively with pop cast had showed fair results (mean Bohler: 28.2; mean AOFAS: 69.3). Conclusion: The overall outcome of operated cases were better than non-operated cases. There is a proportionate relationship between the restoration of Bohler’s and Gissane’s angles and the functional outcome of the patients (SD operative:3.33; SD nonoperative: 1.69; t value: 8.453; P = 0.001). Operative treatment of displaced intra-articular calcaneal fractures gave good results at 1-year follow-up, provided Bohler’s angle was restored to normal range.