Fractures of the calcaneum. A review of 70 patients.
We have assessed the long-term results after operative and non-operative treatment of undisplaced and displaced calcaneal fractures. At a mean of 6.5 years, we reviewed 70 patients with a calcaneal fracture who were divided into four groups: group 1, 18 patients with undisplaced fractures and a normal Böhler's angle (BA) who had been treated non-operatively; group 2, 23 with intra-articular fractures and a BA < 10 degrees who had been treated non-operatively; group 3, 13 with intra-articular fractures and a BA > 10 degrees who had been treated surgically; and group 4, 16 with intra-articular fractures and a BA < 10 degrees who had been treated surgically. The results were assessed by a clinical score considering pain, return to work, return to physical activity, change in shoe-wear and the requirement for subtalar arthrodesis. Patients with undisplaced calcaneal fractures had a good outcome. Those with displaced fractures treated surgically who presented at follow-up with a BA > 10 degrees had a satisfactory functional outcome and those with displaced fractures who had non-operative treatment had a poor outcome. The poorest outcome was consistently seen in patients who were treated operatively without restoration of BA. Open reduction and internal fixation of intra-articular calcaneal fractures can only be expected to benefit those patients in whom nearly anatomical reconstruction is obtained.
Paul
M
M
Department of Orthopaedic Surgery, University Hospital, Rue Micheli-du-Crest 24, CH 1211 Geneva 14, Switzerland.
Peter
R
R
Hoffmeyer
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016896:Treatment Outcome