Late complications of fractures of the calcaneus

We retrospectively reviewed the results of the operative treatment of forty-three fractures of the calcaneus in forty-two patients (thirty-six men and six women). The operations had been performed a mean of twenty-six months (range, six to seventy-two months) after the injury. An in situ subtalar arthrodesis had been performed in fifteen patients; a subtalar distraction bone-block arthrodesis, in fourteen; a triple arthrodesis, in five; a lateral calcaneal ostectomy, in seven; a transection and proximal transposition of the sural nerve, in seven; and a release of the tibial nerve, in five. The patients were examined at a mean of thirty-two months (range, twenty-six to fifty-two months) after the operation. The difference between the preoperative and postoperative rating scores was used to measure any improvement in function. Pain was partially relieved in thirty-eight (90 per cent) of the patients, function improved in thirty-five (83 per cent), and thirty-two (76 per cent) of the patients returned to work or to a pre-injury level of activity at a mean of eight months (range, four to sixteen months) after the operation. There was a trend (p = 0.07) that the longer the interval between the injury and the operation, the longer the subsequent interval until the patient returned to full activities or work. The most successful results were in the patients who had had a subtalar arthrodesis.