Osteosynthesis for intra-articular calcaneal fractures.
OBJECTIVE
To correlate treatment results of intra-articular calcaneal fractures with their computed tomographic (CT) classification.


METHODS
36 men and 4 women with 48 intra-articular calcaneal fractures (8 bilateral) underwent open reduction and internal fixation with bone grafting via an extensile lateral approach. Based on 2-dimensional CT scans, the fractures were categorised using the Sanders classification. There were 16 type-II, 20 type-III, and 12 type-IV fractures. Radiographs and Maryland foot scores were used for evaluation of the results at a mean of 38 (range, 26-66) months.


RESULTS
Anatomic reduction of the posterior calcaneal facet was achieved in 38 of 48 fractures. The Bohler and Gissane angles were restored to between 92 and 99% of normal, respectively. Despite this, the mean functional scores were 84 in type-II, 83 in type-III and 67 in type-IV fractures.


CONCLUSIONS
Surgical results were superior in type-II and -III fractures. Type-IV fractures fared poorly, despite excellent restoration of calcaneal anatomy; subtalar arthrodesis should have been considered.
Jain
V
V
Department of Orthopaedics, Lady Harding Medical College and Associated Shri Sutcheta Kriplani Hospital, New Delhi, India. cybermakhi@gmail.com
Kumar
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R
Mandal
D K
DK
D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods; D001864:Bone Wires; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices; D016896:Treatment Outcome