Comparative study of conservative versus operative management of closed displaced intraarticular fracture of calcaneum

Author(s): Dr. Naren Gaur, Dr. Naveen Kumar Singh and Dr. Nishat Setia

Abstract: Intraarticular fractures of calcaneum are frequently complex injuries, requiring experience in the diagnosis and management, for favourable results. The historical aspects of calcaneal fracture treatment are difficult to appraise, secondary to varied forms of treatments, classifications, numerous retrospective studies and mixture of diagnoses and results. Significant controversy remains over the results of non-operative treatment. Due to the lack of standardization, accurate comparisons cannot be made between reported surgical and conservative treatment modalities to precisely determine the long term and short-term functional results between each method. Here is a cohort prospective study to compare patients of closed displaced intra-articular fracture of calcaneum. 30 patients were taken for this study out of which fifteen patients were treated operatively and fifteen patients were treated non-operatively. Patients were followed up to an average of 1 year. The functional outcome was measured by AOFAS hind foot score. It was observed that under the operative group 73.3% of the patients had excellent results, 13.3% had good result and 6.7% each had fair and poor results. Similarly, under the conservative group 53.3% of the patients had fair results, 26.7% had good result, 20% had poor result and none of the patients had excellent results. Further, it was observed that there was a significant difference in results between the two groups (p value <0.001). We through our study and reviewing the literature conclude that the operative management by Locking Calcaneal Plate being a low profile, mouldable, multiplanar with locking screw shows satisfactory results with improved functional outcome and less complications as compared to conservatively managed displaced intra articular calcaneal fracture by below knee cast.

DOI: https://doi.org/10.22271/ortho.2019.v5.i4n.1774