[Surgical treatment of displaced intra-articular fractures of the calcaneus in elderly patients].
OBJECTIVE
To study the clinical effects of surgical treatment of displaced intra-articular fractures of the calcaneus in elderly patients, and to discuss the operative indications.


METHODS
From January 2000 to December 2007, 24 elderly patients with 26 fractures underwent open reduction and internal fixation for a displaced intra-articular fracture of calcaneus, which included 18 feet of 18 males and 8 feet of 6 female, with an average age of 67 years (range, 60 to 75 years). According to Sanders classification based on CT scanning, 13 fractures were rated as type II, 12 as type III and 1 as type IV. Böhler angle and Gissane angle were measured preoperatively and postoperatively and foot function was assessed with Maryland foot score system.


RESULTS
Twenty-four cases with 26 feet were followed up for an average of 18.4 months (range, 12 to 26 months). Mean Böhler angle was (10.4 +/- 8.2) degrees preoperatively and (27.8 +/- 7.4) degrees postoperatively and mean Gissane angle was (136.5 +/- 10.3) degrees preoperatively and (124.3 +/- 4.2) degrees postoperatively. The difference between preoperative and postoperative values was found with statistically significant (P < 0.05). The results were excellent in 5 feet, good in 16 feet, fair in 4 feet and poor in 1 foot. There were 3 cases of wound necerosis, 2 cases of wound infection, 1 case of sural nerve injury and 6 cases of posttraumatic subtalar arthritis complications.


CONCLUSIONS
Good clinical result could be obtained with surgical treatment in elderly patients with displaced intra-articular fractures of the calcaneus. Open reduction appears to be an acceptable method of treatment for displaced calcaneal fractures in elderly patients if they have good general conditions.
Department of Orthopaedics, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325007, Zhejiang, China. huachenyu@126.com
Hua-Chen
HC
Yu
Jian-Bin
JB
Wu
Hua
H
Chen
You-Ming
YM
Zhao
Lin-Wei
LW
Chen
D000368:Aged; D002111:Calcaneus / Q000293:injuries* / Q000503:physiopathology; D005260:Female; D006801:Humans; D057072:Intra-Articular Fractures / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology