International Journal of Orthopaedics Sciences
2018, Volume 4 Issue 4
Functional outcome of patients after open reduction internal fixation in displaced intra articular calcaneal fractures
Author(s): Dr. Krishnaraj V, Dr. Shanavas EK and CS Vikraman
Abstract: Background There are lot of controversies with management of calcaneal fractures. In this prospective study, we studied the functional outcome of surgically treated displaced intra-articular calcaneal fractures. Aim To evaluate the functional outcome of patients following open reduction internal fixation in displaced intra-articular calcaneus fractures under Dept. of Orthopaedics – Govt. Medical College Hospital, Thiruvananthapuram during the period of 2016-2017. Functional outcome is measured in terms of pain and function. Materials and Methods 72 patients admitted with displaced intra-articular calcaneal fractures and managed with Open Reduction Internal Fixation were observed for 6 months. All fractures were fixed with calcaneal plates, by an extensile lateral approach. Regular follow ups are made at 1 month and 6 months. Functional result was compared by using Maryland foot score and also Bohler’s angle. Results: Incidence is much more common in males (90.3%). 20-40 year age group is most commonly affected. The spinal injuries were the most common associated injury (30.6%). Of 72 fractures, 26 were Sander’s type IV (36.1%), 25 type II (34.7%) and 21 Type III (29.2%) fractures. 30 patients had Bohler’s angle 21-40, 42 had less than 20. The proportion of patients having Bohler’s angle <20deg were more in Sander’s type IV as compared to types II and III. As Bohler’s angle increases, Maryland Foot Score also increases. Complications were present in 18 (25%) patients. Functional outcome according to Maryland Foot Score were excellent in 23.6%, good in 45.8%, fair in 23.6% and poor in 6.9% cases. Complications include stiffness, implant prominence, wound healing problems, infection and varus deformity. Conclusion: Open reduction internal fixation is the ideal treatment for displaced intra-articular calcaneal fractures. Use of proper surgical timing and technique can give better results in majority of patients, avoiding many complications.