Surgical Treatment of Calcaneal Comminuted Intrarticular Fractures: Long-Term Follow-Up

Abstract

There is a controversy whether the comminuted calcaneal fractures should benefit more from conservative or from surgical treatment. Aiming to contribute to this unsolved clinical question we reviewed the long-term outcome (up to 96 months) of in 44 patients (mean age 35 years) with 47 calcaneal fractures who were treated surgically. In these patients open reduction and internal fixation were performed using a calcaneal reconstruction plate. The functional outcome was measured according to the Rowe Score and the level of pain by Visual Analog Scale. The objective outcome was estimated by the current radiographs. The clinical results were good to excellent in 69% of patients. Poor outcome observed in one patient who developed Complex Regional Pain Syndrome in his foot. The radiographic evaluation showed satisfactory reconstruction (according to the Boehler angle measurements) in 35 of operated calcanei. These results indicate on the satisfactory outcome of surgical treatment in the majority of the patients who were diagnosed with comminuted fracture of calcaneus.

Early Results of Surgical Treatment of Intra-Articular Calcaneal Fractures Using T-Shaped Plates

“…The mean preoperative Bohler angle was 12.6 0 and immediate postoperative was 28 0 and at final follow up was 27.6 0 and it was maintained in the normal range (20° to 40°) in all the patients which is a better result than Santosha et al (22) where the angle was restored and maintained only in 25 (83.3%) feet after 24 months of follow-up. Haddad et al (25) noted that restoration of Bohler's angle in 74% of calcaneum, while 86.6% of calcaneal restoration was reported in a study conducted by Jain et al (26) who found that the mean Bohler's angle improved from preoperative 4.15° to immediate postoperative 27.69° which was decreased to 25.47° at final follow-up.…”