Online ISSN: 2515-8260

Keywords : Calcaneal fractures

Operative and non-operative treatment of intraarticular displaced calcaneal fractures: a comparative study

Dr. Jasani Ajay Batuk, Dr. Jayur Solanki, Dr. Parimal Patel

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 3, Pages 132-137

The treatment of intra-articular displaced calcaneal fracture is debatable. We conducted comparative study to operative and non-operative treatment for intra-articular displaced calcaneal fractures. Patients were assigned to two groups based on the treatment given (operative and non-operative) and were regularly followed for a period of 12 months. The outcome measures were assessed by Modified Rowe’s Score (MRS), Visual Analogue e Scale (VAS) and The American Orthopaedic Foot and Ankle Society (AOFAS) scale. The outcome related to patient’s job was noted after one year and compared with pre-injury status. 46 calcaneal fractures were studied. 22 of them were operated and 24 were treated conservatively. Out of 22 operated cases, Bohler’s angle was restored in 18 cases and these had good results with all three outcome scores at 1 year follow up and remaining 4 cases showed fair results. 24 cases treated with cast also showed fair results. The overall outcome of operated cases were better than non-operated cases Operative treatment of displaced intra-articular calcaneal fractures gave good results at one year follow up, provided Bohler’s angle was restored to normal range. Non operative treatment gave fair results. Complications were seen both with operative and non-operative treatment.

A Study of Efficacy of Internal Fixation of Calcaneum Fractures

Mrunal Chakravarthy Goutham, Anil Kumar Mettu, Mangalapuri Rajesh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1787-1794

Background: Aim & Objective: The purpose of the present study is to verify the
functional outcome of the internal fixation, in calcaneum fractures.
Materials and Methods: Our study included patients reporting to Osmania General
Hospital, Hyderabad from June 2017 to October 2019 treated by internal fixation using
various modalities and those who were available for follow up. All patients above
l8years of age with communitedcalcaneum fractures, Fresh fractures and Patients
should be walking prior to the fracture.
Results: Thirty patients with comminuted calcaneal fractures were operated from June
2017 till October 2019 Of the 30 patients 28 were male 2, were female with a mean age
of 37 years, 2 patients had bilateral fractures.18 had left sided fractures while 12 had
right sided fractures and mode of injury for the 23 patients was fall from a height and
RTA for 67patients.20 patients had SANDERS type 3 fracture and 10 patients had
SANDERS type 2 fractures. Days of hospital stay varied from 14 to 22 days {mean 16.04
days}. Post operatively 14 patients had swelling and 6 patients had persistent pain,2 had
superficial infection and one had deep infection. The infections have healed with
antibiotics and regular dressing. Of the 30 patients, 9 had excellent results, 15 had good
results, 4 had fair results, 2 had poor results. Hence we concluded from the above
findings the internal fixation helps in improving the functional outcome of the patients
in view of their physical and radiological findings.
Conclusion: The technique of plate fixation with a lateral approach is good with regards
to fracture union and functional outcome. It also shows that anotomical reduction in
terms of the correction in BOHLER'S and GISSANE'S angle plays an important role in
determining the good functional outcome.

Outcome following open reduction and internal fixation of intra artucular calcaneum fractures in terms of complications: A prospective study

Dr. Shekar M, Dr. Vivekananda BR, Dr. Gaurav Sen, Dr. Syed Farhan Bukhari

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2770-2787

Background: Intraarticular fractures account for approximately 75% of calcaneal fractures and historically have been associated with poor functional outcome. The management of intra articular calcaneal fractures remains a controversy with strong arguments supporting both conservative & operative managements. Significant controversy remains over the results of nonoperative versus operative treatment. Lack of standardization of results has made it difficult to compare studies that have evaluated outcomes (1).
Aims and Objective: To evaluate the functional and radiological outcome of intra-articular calcaneal fractures managed surgically with a plate in terms of Bohler’s and Gissane’s angle, rate of radiological union and AOFAS score.
Methods: A prospective study including 25 patients with intra-articular calcaneal fracture who met the inclusion criteria was conducted in SGITO, Bangalore, between November 2019 and November 2020. Patients were managed surgically with plate fixation and were followed up regularly at 6 weeks, 12 weeks, 24 weeks and 1 year. Radiological outcome and functional outcome evaluated using AOFAS score.
Results: Mean age of the patients was 33.6 years. Mean time duration between injury and surgery was 7.8 days. The mean time for fracture union was 13.64±2.56 weeks. The difference between pre and post-operative mean Bohler’s and Gissane’s angle was statistically significant with p value <0.01. Out of 25 patients 4 patients (16%) had excellent, 16 patients (64%) had good, 4 patients (16%) had fair and 1 patient (4%) had poor outcome.
Conclusion: We conclude that with proper pre-operative planning, timing of surgery, intra-operative expertise of the surgeon and post-operative care, surgical management of intra-articular fracture using locking plate, gives a better outcome and minimal complications.