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.
Dr. Krishnaraj V, Dr. Shanavas EK, CS Vikraman. Functional outcome of patients after open reduction internal fixation in displaced intra articular calcaneal fractures. Int J Orthop Sci 2018;4(4):15-19. DOI: 10.22271/ortho.2018.v4.i4a.04