[Fractures of the calcaneus]

The authors present the results of another investigation of a group of casualties with fractures of the calcaneum treated by open reposition and stabilization with a splint and screws in 1994 to 1996, followed up after an interval of 57-74 months after the injury, on average after 66 months. Sixteen patients (20 calcanea) could be followed up, 7 patients were lost (8 calcanea). Again two evaluation patterns were compared. According to the authors the results were evaluated 12x as excellent, 6x as good and 2x as poor. On subjective evaluation 13 patients were satisfied, another three satisfied with reservations. During the subsequent follow up no complications developed. In all patients the osteosynthetic material was extracted and in one also ossificates in the planta. In two patients spontaneous talocalcaneal fusion occurred. Since 1997 in the Casualty Hospital as the basic method for treatment of dislocated intraarticular fractures of the calcaneum ligamentotaxis by exterior fixation is used (the authors give an account of all therapeutic methods used between 1994 and 2000). The authors evaluated a group of 28 casualties (36 fractures of the calcaneum) treated by external fixation, 18-81 months after injury, on average after 34.3 months. The evaluation proceeded in the same way. According to the authors' pattern the result was excellent 8x, good 13x and poor 15x. Spontaneous talocalcaneal fusion occurred 9x, 2x desis was performed and 1 desis is planned. As to subjective evaluation, 11 patients were satisfied, 15 were satisfied with reservations and two were not satisfied. According to the authors' opinion to achieve reposition of fragments of a fractured calcaneum in addition to other possibilities open reposition and synthesis using screws (possibly plate and screws) remains the basic method.