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Osteosynthesis for intra-articular calcaneal fractures
1Department of Orthopaedics, Lady Harding Medical College and Associated Shri Sutcheta Kriplani Hospital, New Delhi, India. cybermakhi@gmail.com
Purpose:
To correlate treatment results of intra-articular calcaneal fractures with their computed tomographic (CT) classification.
Methods:
36 men and 4 women with 48 intra-articular calcaneal fractures (8 bilateral) underwent open reduction and internal fixation with bone grafting via an extensile lateral approach. Based on 2-dimensional CT scans, the fractures were categorised using the Sanders classification. There were 16 type-II, 20 type-III, and 12 type-IV fractures. Radiographs and Maryland foot scores were used for evaluation of the results at a mean of 38 (range, 26-66) months.
Results:
Anatomic reduction of the posterior calcaneal facet was achieved in 38 of 48 fractures. The Bohler and Gissane angles were restored to between 92 and 99% of normal, respectively. Despite this, the mean functional scores were 84 in type-II, 83 in type-III and 67 in type-IV fractures.
Conclusion:
Surgical results were superior in type-II and -III fractures. Type-IV fractures fared poorly, despite excellent restoration of calcaneal anatomy; subtalar arthrodesis should have been considered.
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