Treatment of Intra - articular Calcaneal Fracture with Open Reduction and Internal fixation

Kim, Keun Woo; Tae, Suk Kee; Lee, Jae Won; Park, Yoon Soo; Nam, Il Hyun

Abstract

Calcaneus was the most commonly involved bone among the tarsal bone fractures. Although various methods have been practiced in treating calcaneal fractures, controversy exists between conservative and operative ones. Also there have been many complications such as persistent pain and limitation of motion on subtalar joint which compromised final result. The purpose of this study is that open reduction of the subtalar joint, especially posterior facet joint, could reduce the complications. Twenty seven cases of displaced intra-articular fracture of calcaneus were treated with open reduction, internal fixation, and cancellous bone graft from 1984 to 1989 at the Department of Orthopedic surgery, Kang-Nam General Hospital Public Corporation. Seventeen cases were analysed with more than one year follow-up and summarized as follow:1. All of the cases were the type IV and V on the basis of Rowe's classification. 2. The lateral approach was used in all cases. 3. The pre-operative Bohler's angle was from âˆ’30°to 15°(average âˆ’1.4°). The postoperative Bohler's angle was from 15°to 40°(average 24.5°), which was increased significantly. 4. Based on Rowe's grading, excellent and good results were obtained 13 cases. 5. Among 3 cases of fair result, arthritis of the subtalar joint occurred in 2 cases and peroneal spasm in one. In one case of poor result, postoperative infection occurred. 6. It was thought that open reduction of the posterior facet joint of calcaneus could restore the congruity of subtalar joint near to normal, and contributed to a large extent to the decrease of foot pain commonly developed after calcaneal fracture.