Operative treatment of displaced intraarticular fractures of the calcaneus

Kim, Ki Soo; Choi, Yong Soo; Han, seung Chae; Shon, Kwang Soo

Abstract

As technology in imaging has improved, we have learned more of the anatomical features of these fractures, and onw several objective studies in the literature with sufficient follow up recommend surgical treatment for some displaced intraarticular fractures of the calcaneu. The purpose of this study is to report the results of the open reduction with rigid internal fixation for displaced intraarticular fractures of the calcaneus. from March 1994 to December 1996, the author managed twenty-nine displaced intraarticular fractures of the calcaneus in twenty-three patients with open reduction via extended lateral approach and internal fixation using the plate. The fractures were classified according to Essex-Lopresti with the lateral radiograph and according to Sanders with the computed tomograph. Clinical results were assessed the pain, activity, return to work, range of motion, change in shoe size and swelling from creighton-Nebraska health foundation assessment. Among the 29 cases, satisfactory results were obtained in 24 cases(82.9%). We assessed the radioolgic objective parameters such as Bohler angle, crucial angle, height and width of the calcaneus, and the arthritis of the subtalar joint. Radiologically, we showed satisfactory restoration of the calcaneal morphology and severe subtalar arthritis in 4 cases. We found the negative correation between the clinical results and the radiological subtalar arthritis(P=0.038). In managing displaced intraarticular fractures of the calcaneus, open reduction via extended lateral approach and rigid internal fixation seemed to be useful method.