Arularasan Samraj, Madhan Kumar Velu, Lakshmikanth Manickam Ettiappan
The calcaneus is the most frequently injured tarsal bone. Calcaneal fractures have posed a challenge to orthopaedic surgeon for many years. Operative treatment of displaced calcaneal fractures has been a controversial due to tissue condition and wound infection. Anatomic restoration of the three dimensional anatomy of the calcaneum with good wound healing is the ultimate goal of surgical management of calcaneal fractures. Aim: To assess the functional and radiological outcome of displaced intra-articular calcaneal fractures managed by open reduction and internal fixation. Materials and Methods: A prospective study was conducted from June 2021 to Novemeber 2021. A total of 25 patients with intra-articular displaced calcaneal fractures were included in the study. Complete clinical and radiological evaluation was done. The surgical procedure encompassed open reduction and fixation with calcaneal locking plates. Postoperatively, on day three ankle and toe mobilization was begun. Patients were reviewed at 3 weeks, 6 weeks, 3months, 6 months and radiographs in anteroposterior, lateral view and Harrison’s axial view were taken in all patients. The patient was finally reviewed at 24 weeks and assessment of ankle function was done as per the American orthopaedic foot and ankle score –Hind foot scale. (AOFAS). Results: Of the 25 patients under the study, Excellent outcome was seen in 11 patients (44%) and 13 patients (52%) had good outcome and 1 patient (4%) had fair outcome based on AOFAS. The average time for radiological union of calcaneal fracture was 9.24 weeks ranging from 8 to 12 weeks. Conclusion: In our study, Bohlers angle, calcaneal height and restoration of normal anatomy was achieved in most of the patients who underwent open reduction and internal fixation by calcaneal locking plates, which showed a significant correlation between satisfactory functional outcome and restoration of normal anatomy.
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