Abstract :
Background: The treatment of Calcaneal fracture has been controversial. Thirty cases, of calcaneal fractures were treated and evaluated with the objective of assessing the results of percutaneous pin manipulation / primary subtalar arthrodesis/ ORIF & comparing treatment modalities and finding management strategies, depending on type of fractures.
Materials and Methods: Patients with calcaneal fractures presenting at OPD during the study period were admitted, treated and evaluated. Extra-articular fractures were managed mostly by conservative method with a below knee POP cast. Intra-articular fractures were managed by conservative, semi open Essex-Lopresti technique, ORIF with cancellous screws and primary subtalar arthrodesis. Patients were followedup at 6 weeks, 12 weeks and 15 weeks. Paley and Hall criteria were used for evaluation of results.
Results: Functional and radiological review done at last follow-up was used to evaluate the result based on Paley and Hall criteria. Extra-articular fractures had 75% excellent results and 25% good results. Most of the poor results were due to communited type of intra-articular fractures. The overall results were 26.7% excellent, 33.3% good, 16.7% fair and 23.3% poor.
Conclusion: Calcaneal fractures are more common in younger age group and in males than females. Fall from height is the usual mode of injury. Extra-articular fractures constituted 26.7% of all fractures; they had good prognosis and hardly any complications. Intra-articular fractures constitute majority of fractures and are associated with poor functional outcome. Tongue-type can be treated best by Essex-Lopresti technique and Joint depression type deserves an aggressive well planned surgical management.
Keyword :
Calcaneum, Essex-Lopresti types, Intra-articular, Extra-articular, Subtalar joint, Percutaneous, Subtalar arthrodesis,
Bohler’s angle.