Intra-articular Fracture of the Calcaneus: Analysis of Result of Operative Treatment and Prognostic Factor

Chung, Sung Soo; Seo, Jai Gon; Park, Youn Soo; Lee, Chong Suh; Hwang, Tae Kyu

Abstract

The calcaneus is the most commonly fractured tarsal bone, but the appropriate care of calcaneal fracture continue to be an unsolved dilemma. As technology in imaging has improved, operative treatment is more suggested. The purpose of this study is to evaluate the results of operative treatment in intra-articular calcaneal frcture and to analyse the results in accordance with various prognostic factors. We analysed retrospectively 13 patients, 17 intra-articular calcaneal fractures undergone operative treatment. Mean follow-up period was 27 months (range:13 ~ 44 months). There were 11 males and 2 females with 41 year old mean age (range:18 ~ 63 years old). Clinical assessment used the modified Creighton-Nebraska health foundation assessment sheet for fracture of the calcaneus. We obtained excellent result in 7 cases (41.2%), good in 2 cases (11.8%), fair in 7 cases (41.2%) and poor in 1 case (5.8%). Clinically age and body weight, radiologically Bohler angle, fibulo-calcaneal distance and subtalar joint discrepancy are related to the prognosis of intra-articular calcaneal fracture following operative treatment. Postoperative complications are limping (2 case), heel pain (3 cases), hump bump of calcaneus (1 case) and subtalar arthritis (1case). In conclusion, on the basis of our results, there is a relationship between anatomical abnormalities of the heel and a poor clinical outcome. Therefore, in operative treatment of intra-articular fracture of calcaneus, we recommend anatomical reduction, if possible, not only of the subtalar joint but also of the Bohler angle and fibulo-calcaneal distance.