Abstract: Background: Displaced intra-articular fractures of the calcaneus are typically the result of high-energy trauma, such as a fall from a height or a motor vehicle accident. Fractures of the calcaneus remain among the most challenging for the orthopaedic surgeon. Comparative study was performed to evaluate the functional outcomes in intra-articular displaced calcaneum fractures managed with conservative versus operative treatment.
Material and Methods: This study was conducted as a Prospective, comparative, randomized controlled trial on 30 patients with displaced intra-articular calcaneal fractures. The patients had been randomly allocated to either conservative or operative treatment, 15 in each group. Radiological union and Clinical [Modified Rowe score] outcomes were measured at 1 year follow up.
Results: As per Modified Rowe’s score at 1 year follow up, in operative group 6 patients (40%) had excellent, 8 patients (53.33%) had good and only 1 patient (6.66%) had satisfactory outcome. In conservative group, 1 patient (6.66%) had excellent, 7 patients (46.66%) had good, 5 patients (33.33%) had satisfactory and 2 patients (13.33%) had poor functional outcome. Major complications like subtalar arthtritis, peroneal tendinitis and malunion were observed more in conservatively managed group whereas delayed wound healing was observed in 2 operated cases.
Conclusion: We concluded that Displaced Intra articular calcaneum fractures can be better and more effectively treated with open reduction and internal fixation with locking plates as compared to conservative treatment. Early rehabilitation, fewer complications, early weight bearing and better functional recovery was seen with operative treatment.
