Background: Calcaneus fractures are the most common of tarsal bone fractures and displaced intra articular fractures accounts for 60% to &75% of all calcaneal fractures. Fractures of the calcaneus remain among the most challenging for the orthopedic surgeon to manage effectively as these injuries are more destructing and devastating. The management dilemma is still going on regarding conservative or operative treatment for such fractures as there is no clear evidence to delineate the gold standard treatment method which is superior in every aspect.
Material and Method: We have done a prospective study of 58 patients (2 had bilateral fracture) with displaced intra-articular calcaneus fracture after applying strict inclusion and exclusion criteria. We have randomly allocated patients in operative (A, n-30) and non-operative group (B, n-30). We compared clinical, functional and radiological outcomes of both groups.
Results: The mean age in operative group is 34.7 years and in non-operative group is 36.03 year. Average follow-up is 12.4 months and average time of union was 10.1 weeks in operative group while in non-operative group it is 11.03 month and 10.6 weeks respectively. The mean AOFAS score at final follow up of operative group is 84.2 and in the other group it is 79.4. Total 8(39%) patients undergoing operative management have excellent result, 15(50%) have good results,3(10%) have fair and 4(1%) have poor results as compared to other group 4 (13%), 9 (30%), 8(27%), 9(30%) respectively.
Conclusion: Operative management has a better radiological, clinical and functional score in comparison with conservatively managed patients of displaced intra articular calcaneal fracture. However, operative management is also associated with increased number of surgery related complications like long hospital stay, cost effectiveness, local wound healing problems, superficial and deep infection, implant related problems as compared to other group.