European Journal of Molecular & Clinical Medicine

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.

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.