[Operative treatment of displaced intra-calcaneal fractures]

To explore the clinical efficacies of displaced intra-calcaneal fractures with operative treatment.

From January 2005 to December 2010, 103 calcaneal patients (92 males, 11 females) were recruited. The mean age was 45.8 years old (range: 23 - 65). All received operative treatment. They included left calcaneal fractures (n = 51), right calcaneal fractures (n = 40) and bilateral calcaneal fractures (n = 12). All patients were of closed fractures. According to the Sanders classification, there were type II (n = 15), type III (n = 75) and type IV (n = 13). A modified lateral approach with profiled plate fixation was adopted for all. Partial weight-bearing occurred at 6 weeks and full weight-bearing at 12 weeks. Function assessment was made with the American Orthopedic Foot and Ankle Society ankle-hindfoot scale (AOFAS).

The mean follow-up period was 18 months (range: 6 - 30) and the mean healing duration 12 weeks (range: 8 - 15). Two cases had incision dehiscence. After the removal of plate, the skin healed. Eight cases were associated with subtalus arthritis and painful walking. Three cases of caved calcaneal surface appeared after weight-bearing. According to the AOFAS foot score, the outcomes were excellent (n = 83), good (n = 13), fair (n = 5) and poor (n = 2). And the excellent and good rate was 93.2%.

With a modified lateral approach, displaced intra-calcaneal fracture may be treated with a satisfactory clinical efficacy.But an orthopedic surgeon should master skillful surgical techniques.