Publication: Displaced Intra-Articular Calcaneal Fractures: Evaluation of Clinical and Radiological Outcome Following Open Reduction and Internal Fixation with Locking Branched Calcaneal Plate
Date
2017
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Calcaneal fractures are common, but are difficult to manage. Immediate concern
is soft tissue problems, while long term concern is pain as a sequelae of subtalar
arthritis. A consensus has not been reached in the management of calcaneal
fractures.
Objective
This study aims to evaluate clinical and radiological outcomes of the patients
managed with open reduction and internal fixation with Calcaneal Locking Plates
for the displaced intra-articular calcaneal fractures presenting in Dhulikhel Hospital,
Kathmandu University Hospital.
Method
This was a prospective study, conducted on displaced intra articular calcaneal
fractures from January 2014 through December 2016. The patients underwent open
reduction and internal fixation with Locking Branched Calcaneal Plates through the
extensile lateral approach. Post-operatively, ankle was mobilized after two weeks.
Weight bearing was started after 12 weeks. Patients were evaluated clinically with
Maryland foot score and radiologically with measurements of Boehler’s and Gissane
angle.
Result
Twenty-two cases of calcaneal fractures managed with open reduction and internal
fixation with Locking Branched Calcaneal Plates were available for final evaluation.
Seventeen of the enrolled patients were males in their third decade of life. On
average, calcaneal fractures were operated on seven days after the injury. Sanders
Type II were seen in 68.2% of the cases and Sanders Type III were in 31.8%. Mean
follow-up duration was 21.5 months. The average Maryland foot score was 77.27.
Seventeen cases (77.13%) had good, four cases (18.2%) had fair, and one case (5.5%)
had poor outcome score. There was statistically significant improvement in Boehler’s
and Gissane angle across all enrolled patients.
Conclusion
Displaced intra-articular calcaneal fractures treated operatively with open reduction
and internal fixation with Locking Branched Calcaneal Plates through the extended
lateral approach, with proper planning of operation and surgical techniques in soft
tissue handling, results in good clinical as well as radiological outcomes.
KEY WORDS
Boehler’s angle, calcaneum, calcaneal locking plates, maryland foot score, ORIF
Description
Shrestha R,1 Shrestha D,1 Kayastha SR,1 Winker H2
1Department of Orthopaedics and Traumatology
Dhulikhel Hospital, Kathmandu University Hospital
Dhulikhel, Kavre, Nepal.
2Department Orthopaedics and Traumatology
HELIOS Klinikum
Reichartstrasse 24
99094 Erfurt, Germany.
Keywords
Boehler’s angle, calcaneum, calcaneal locking plates, maryland foot score, ORIF