Outcome of Calcaneal Platting after fracture: two year follow-up
Abstract
The present study is aimed to analyse the results of surgical outcome of the intra articular reduction of Calcaneal fractures fixed using better implants. The treatment of Calcaneal fractures have evolved from conservative to operative management during the last few years thanks to better understanding of fracture pattern and availability of better implants.
Methods: Thirty intra-articular fractures were prospectively evaluated followed up for mean 18 months. Calcaneum plates and locking reconstruction plates and were used using the lateral approach. McMaster technique was used to measure the final inversion and eversion of the foot.
Results: Height and width of the Calcaneum were restored within 0.5-1 cm as compared to the normal side. The results were extrapolated as excellent in 13 patients (43%), good result in 11(37%) patients and fair in 4 (14%) and poor in 02 patients (7%) using Maryland foot and AOFAS scoring system.
Conclusion: Surgical management is the treatment of choice for the majority of Calcaneal fractures. Amount of initial injury is the primary determinant of future outcome especially comminution, soft tissue compromise and joint surface destruction. The value of Bohler angle >20 degrees after reduction is good outcome factor. 86% patients have excellent and good results as per AOFAS and Marlyland foot score. The gait and joint range of motion are known to improve gradually with time and exercise.
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2. Aktuglu K, Aydogan U. The functional outcome of displaced intra-articular calcaneal fractures: a comparison between isolated cases and polytrauma patients. Foot Ankle Int. 2002; 23(4):314-318.
3. Sanders R. Displaced Intra-Articular Fractures of the Calcaneus The Journal of Bone and Joint Surgery.2000 Feb.82-A, No.2,225-250. [PubMed]
4. Böhler, L.Diagnosis, pathology, and treatment of fractures of the os calcis. J. Bone and Joint Surg.1931 Jan.,13: 75-89.
5. Paul M.,Peter R., Hoffmeyer P. Fractures of the calcaneum.A review of 70 patients. J bone Joint Surg [Br] 2004;86-b:1142-5. [PubMed]
6. Gaskill T., Schweitzer K. ,Nunley J. Comparison of Surgical Outcomes of Intra-Articular Calcaneal Fractures by Age. J Bone Joint Surg (Am). 2010;92:2884-9. [PubMed]
7. Wei SY, Okereke E. Esmail AN, Born CT, Delong WJ. Jr. Operatively Treated Calcaneus Fractures: To Mobilize Or Not To Mobilize. The University Of Pennsylvania Orthopaedic Journal 2001;14:71-3. 5.
8. Ibrahim T, Beiri A, Azzabi M, Best AJ, Taylor GJ, Menon DK. Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society clinical rating scales. . J Foot Ankle Surg. 2007 Mar-Apr;46(2):65-74. [PubMed]
9. Heffernan G, Khan F, Awan N, Riordain CO, Corrigan J.A comparison of outcome scores in os calcis fractures. Ir J Med Sci. 2000 Apr-Jun;169(2):127-8. [PubMed]
10. Broden B. Roentgen examination of subtaloid joint in fractures of calcaneus. Acta Radiologica. 1949; 3: 85-91. [PubMed]
11. Essex-Lopresti P. The mechanism, reduction technique, and results in fractures of the os calcis. Br. J. Surg. 1952;39:395-419. [PubMed]
12. Benirschke S., Sangeorzan B. Surgical management of calcaneal fractures. CORR No.292, July 1993. [PubMed]
13. Estwood DM, Langkamer VG, Atkins RM. Intra-articular fractures of the calcaneum. Part II:open reduction and internal fixation by the extended lateral transcalcaneal approach.J Bone Joint Surg [Br] 1993;75-B:189-95. [PubMed]
14. Abidi NA, Gruen GS. Operative techniques in open reduction and internal fixation of calcaneal fractures. Operative Techn. in Orthop. 1999; 9:239-46.
15. Micheal McMaster: Technique of measuring sublatar joint movement JBJS Vol.58-B, Feb.1976.
16. Harvey EJ, Grujic L, Early JS, Benirschke SK, Sangeorzan BJ. Morbidity associated with ORIF of intra-articular calcaneus fractures using a lateral approach. Foot Ankle Int. 2001; 22:868-73. [PubMed]
17. Leung KS, Yuen KM, Chan WS. Operative treatment of displaced intra-articular fractures of the calcaneum: medium-term results. J Bone Joint Surg Br. 1993; 75:196-201. [PubMed]
18. Kennedy JG, Jan WM, McGuinness AJ, Barry K, Curtin J, Cashman WF. An outcomes assessment of intra-articular calcaneal fractures, using patient and physicians assessment profiles. Injury 2003; 34:932-6.
19. Thermann H, Krettek C, Hufner T. Management of calcaneal fractures in adults: conservative versus operative treatment. Clin Orthop 1998;353:107-24. [PubMed]
20. Thordarson DB, Krieger LE. Operative vs. nonoperative treatment of intra-articuiar fractures of the calcaneum: a prospective randomized trial. Foot Ankle int1996;17:2-9.
21. Buckley R, Tough S, McCormack R, et al. Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures. J Bone Joint Surg [Am] 2002;84-A:1733-44.
22. Sanders R, Gregory P. Operative treatment of intra-articular fractures of the caicaneus. Orthop Clin North Am 1995:26:203-14. [PubMed]
23. Heier KA, Infante AF, Walling AK, Sanders RW. Open fractures of the calcaneus: soft-tissue injury determines outcome. J Bone Joint Surg [Am} 2003; 85:2276-82. [PubMed]
24. Zwipp H, Tscberne H, WQlker N, Grate R. Intra-articular fracture of the calcaneus. Classification. Unfallchirurg, 1989;92:117-129. [PubMed]
25. Folk JW, Starr AJ, Early JS. Early wound complications of operative treatment of calcaneus fractures: analysis of 190 fractures. J Orthop Trauma 1999;13:369-72. [PubMed]
26. Loucks C, Buckley R. Bohlers angle: correlation with outcome in displaced intra-articular calcaneal fractures. J Orthop Trauma. 1999; 13:554-8. [PubMed]
27. Longino D, Buckley RE. Bone graft in the operative treatment of displaced intra-articular calcanea! fractures: is it helpful? J. Orthop Trauma. 2001; 15:280-6. [PubMed]
28. Leung KS, Yuen KM, Chan WS. Operative treatment of displaced intra-articular fractures of calcaneum. J Bone Joint Surg (Br). 1993; 75: 196-201. [PubMed]
29. O’Farrel DA, OByrne JM, McCabe JP, Stephens MM. Fractures of the os calcis; improved results with internal fixation. Injury 1993; 24:263-5. [PubMed]
30. Zeman P, Zeman J, Matejka J, Koudela KActa, Long-term results of Calcaneal fracture treatment by open reduction and internal fixation using a calcaneal locking compression plate from an extended lateral approach Chir Orthop Traumatol Cech. 2008 Dec; 75(6):457-64.