Abstract: Background: Use of bone graft or bone graft substitutes during open reduction and internal fixation of the fractures of the calcaneum is controversial. The present study was an endeavor to evaluate the postoperative change in Bohler and Gissane angles after open reduction and internal fixation without bone grafting of Sanders type 2 & 3 fractures of the calcaneum.
Method: 22 cases of closed Sanders type 2 and 3 fracture of the calcaneum were operated by open reduction and internal fixation with calcaneal locking plates without bone grafting. The change in Bohler and Gissane angles from immediate post-operative period to a follow up of 3 and 6 months was measured. AOFAS score was evaluated at 6 months follow up.
Results: Out of 22 cases 3 were lost to follow up in the initial 3 months and 1 was lost to follow up after 3 months. A statistically significant change in Bohler and Gissane angles from preoperative to post-operative period was found the change in Bohler and Gissane angle from immediate post-operative period to 3 months follow up was not statistically significant. The change in Bohler and Gissane angle from immediate post-operative period to 6 months follow up was also not statistically significant. At 6-month follow-up, mean AOFAS score of 18 cases was 81.7 (range 58-98). 4 patients had excellent result, 11 had good result and 3 patients had fair result and no patient had poor result. The average AOFAS score of 18 cases was 81.7 (range 58-98) at 6-month follow-up. 4 patients had excellent result, 11 had good result and 3 patients had fair result and none had poor result.
Conclusion: The present study had a low wound complication rate, good functional score, absence of bone graft donor site morbidity and allograft complications. It did not show statistically significant change in the Bohler and Gissane angles even at 6 months follow up, thereby implying that there is no loss of reduction of the fracture in the absence of bone grafting.
