Clinical and radiographic analysis of calcaneal fracture surgically treated

Abstract

Objective: This study assessed clinically and radiographically patients who underwent surgery for articular calcaneal fractures. Methods: We evaluated 10 patients who underwent surgery at a type I trauma center between January, 2014 and July, 2015. All surgical procedures were performed by lateral accesses, 6 procedures used a L-shaped extended lateral incision and 4 modified Palmer access. Fractures were classified using the Sanders computed­tomography classification. All patients were clinically examined based on the AOFAS score for ankle and hindfoot and radiographically evaluated by comparison of of Bohler and Gissane angles before and after surgery. Results: All patients were men aged between 24­52 years old. The time between surgery and application of questionnaires ranged between 4 and 19 months. Based on Sanders’ classification, 7 fractures were type III, 2 were type II and 1 was type IV. We excluded open fractures, joint fractures type I and extra articular fractures. Patients with less than 4 months postoperatively were excluded. In addition, we did not consider early complications of surgical treatment. Parameters of AOFAS scale for foot and ankle were 26±11.7 for pain, 29.6±11.7 for function and 8.6±1.0 for alignment, total mean score obtained in this study was 64.2±21.8 points. Mean preoperative Gissane angles was 123.3º±24.8º and Böhler angle was 12.6º±13.3º. After surgery the mean Gissane angle was 113.1º±5.7º and Böhler angles was± 24.0º 7.6º. Conclusion: The surgical treatment of calcaneal fractures can restore Böhler and Gissane angles and provide adequate joint congruency of the posterior facet.