Function After Surgical Treatment of Calcaneal Fractures Using Various Methods

Background: The impact that various methods of calcaneal fracture treatment have on functional outcomes is not thoroughly understood. The purpose of this study was to analyze the impact of calcaneal fractures on the level of physical activity and foot and ankle mobility following various fixation methods. Methods: In our two-center retrospective analysis, we compared treatment outcomes of intra-articular calcaneal fractures in 50 patients treated with the Ilizarov method and 49 patients who underwent internal plate fixation. The following parameters were analyzed: range of motion of the foot and ankle joint; the UCLA Activity Scale, the Saltin-Grimby scale, and the Visual Analog Scale (VAS) of Activity. No multivariable adjustment was performed. Accordingly, between-group comparisons are unadjusted, except where stratified analyses are indicated. Results: Postoperatively, a significant improvement was noted in terms of UCLA Activity parameters and the Saltin-Grimby score in the Ilizarov group. A comparison of post-treatment physical activity levels in the two groups revealed significantly better scores in the Grimby scale and VAS activity in the Ilizarov group than in the internal fixation group. The ranges of motion in the Ilizarov group showed significantly worse mobility in the operated limb than in the intact limb. The ranges of dorsiflexion, foot inversion, and foot eversion in the ORIF group were comparable for the treated and intact limb. A comparison of ranges of motion in the study groups showed significantly lower ranges of motion in the Ilizarov group than in the ORIF group. Conclusions: Calcaneal fracture treatment with the Ilizarov method may be associated with better physical activity levels than internal plate fixation. Foot and ankle mobility following calcaneal fracture treatment is better in patients treated with internal plate fixation. The results should be taken with caution due to the lack of randomization, two-center design and the retrospective nature of the study.