Our Experience in the Treatment of Calcaneus Fractures

Abstract

Treatment of Calcaneus fractures needs improvement of modern methods. The purpose of the work is to reveal the structural and functional advantages of the results of surgical treatment of patients with intra-articular fractures of the calcaneus with the use of bone plastic. Material and methods. Case histories of 51 patients treated surgically at the clinical bases of the Department of General Surgery between 2014–2019, retrospectively studied for impressionable intraatricular fractures of 53 calcaneus bones with displacement. The average age of trauma victims was 34.7 ± 1.6 years (26 to 51 years), women - 9 (17.64%), men - 42 (82.35%). All patients operated by open reduction and osteosynthesis (group A; n = 10; 19.6%), and in combination with an osteoplasty by autograft from the iliac crest, biocermic implant (group B; n = 37; 80.4%). Results. At 18 months, excellent results (100–90 points for AOFAS) were achieved in 14 (41.6% - group A; 58.4% - group B) patients, good (89–80 points for AOFAS) in 23 (42, 8% - group A; 57.2% - group B) patients, satisfactory (79-70 points for AOFAS) - in 10 (60.0% - group A; 40.0% - group B) patients, unsatisfactory (less from 70 AOFAS points) - in 4 (75.0% - group A; 25.0% - group B) patients. Conclusions. The use of a bio-ceramic bone implant has proven to be a promising direction for osteoplastic interventions with good deformation resistance in the long term. Replacement of bone defect with an auto-osseous graft at the reference osteoplasty in separate terms showed higher bone density compared to none, but less than when using a bioceramic filler Post-operative deformity of the calcaneus testifies to the difficulties of treatment of this pathology, which requires further search for the most optimal materials for replacement of the bone cavity in order to achieve the possibility of early mobilization, preservation of the anatomic structure of the calcaneus, congruence of joint surfaces, prevention of complications.