Treatment of Joint Depression Intraarticular Calcaneal Fractures with and without Graft

Abstract

Intra-articular calcaneal fracture is one of the most challenging fractures in orthopedic surgery. The main complications of intra-articular calcaneal fractures are postoperative wound complications, subtalar arthritis, malalignment and subtalar stiffness.Conversion of the operative technique from the classic L shaped incision to the mini-invasive sinus tarsi approach renders the wound complications as less as possible. Subtalar arthritis can be minimized by anatomical reduction of the posterior facet. Malalignment can be simply prevented by calcaneal tuberosity reduction and fixation by percutanouscannulated screws. Early subtalar range of motion without weight bearing can overcome the subtalar stiffness.In this study, we included 20 patients with unilateral intra-articular calcaneal fracture without ipsilateral lesions. The patients were treated by open reduction and internal fixation through sinus tarsi approach. The patients were divided in two groups. The first group A were treated by the mentioned above technique without operative supplementation of iliac bone graft. The second group B were treated by the same technique with supplementation of iliac bone graft.Significant improvement was observed in the two groups regarding pain, AOFAS score. No significant difference between the two groups apart from that the group B treated with supplementation of iliac bone graft had earlier bone consolidation and consequently earlier weight bearing which allow for rapid return to daily activities.