Therapeutic efficacies of bone grafing for calcaneal intra-calcaneal fractures

Abstract

To evaluate the efficacies of treating intra-calcaneal fractures with bone grafting. From January 2005 to October 2011, a total of 182 calcaneal patients underwent operations for closed fractures. There were 159 males and 23 females with an average age of 41.2 years old. The fractures were of the following types: left calcaneal (n = 68), right calcaneal (n = 86) and bilateral (n = 28). According to the Sander's classification, there were type II (n = 27), type III (n = 109) and type IV (n = 46). And they were divided into bone graft (n = 94) and non-bone graft (n = 88) groups. All of them underwent a profiled plate fixation via a lateral approach. No external fixation was necessary and early ankle functional exercises started postoperatively. They handled partial weight-bearing at Week 6 and full weight-bearing at Week 12. Their outcomes were assessed by the American Orthopedic Foot and Ankle Society ankle-hindfoot scale (AOFAS) while classification comparison affected the prognosis (P < 0.05). The follow-ups of 10 patients were lost at Month 3. And 172 cases were followed up for an average period of 14.2 months (range: 9 - 16). The average healing duration was 12 weeks (range: 6 - 15). None of follow-up cases had any complication, such as vascular and nerve injury and osteomyelitis. Twenty-nine cases in the non-bone graft group had articular cave-in after weight bearing. And 21 cases were associated with subtalar arthritis. And in the bone graft group, there was no articular cave-in and only 1 case was associated with subtalar arthritis. The outcomes of bone graft and non-graft groups were as follows: excellent (n = 68), good (n = 20), fair (n = 5) and poor (n = 1) vs. excellent (n = 44), good (n = 26), fair (n = 7) and poor (n = 9). The rate of excellent and good was 87.9%. And the post-operative AOFAS scores had statistical differences between 2 groups (P < 0.05). Bone grafting is important for improving the therapeutic efficacies for intra-calcaneal fractures.