The results of conservative treatment of intra-articular fractures in the calcaneum

Abstract

Objectives: We evaluated the results of conservative treatment for displaced intra-articular fractures of the calcaneum and investigated the implications of radiologic and clinical signs on the outcome. Methods: Thirty-three patients (18 males, 15 females; mean age 38 years; range 18 to 61 years) with displaced intra-articular calcaneum fractures were treated with cast immobilization and non-weight bearing. According to the modified Essex-Lopresti classification, the fractures were type-a (n=2), type-b1 (n=5), type-b2 (n=4), type-c1 (n=11), type-c2 (n=7), and type-d (n=4). The results were evaluated using the protocol and scoring system by Rowe et al. The mean follow-up was 3.8 years (range 1.5 to 8 years). Results: Excellent or good results were achieved in 22 patients (66%), while 11 patients (34%) had fair or poor results. Type-b2, type-c2, and type-d fractures were associated with worsening results. Increased heel width, decreased Bohler angle, and male sex were associated with unsatisfactory results; however, no relationship was found between secondary osteoarthrosis and unsatisfactory results. Conclusion: Our results suggest that conservative management of displaced intra-articular fractures of the calcaneus is unsatisfactory.