title: Mal-united fracture of calcaneum treated with lateral decompression.
abstract: Fracture calcaneum is commonly complicated with mal-union. Mal-union is usually presented with broadening of the lateral wall of the calcaneum, irregularity of the sub-talar joint and loss of the vertical height of the body of calcaneum with varus rotation. In this study twenty three (n=23) patients underwent a lateral decompression for pain on lateral aspect of foot on walking and tip toeing, secondary to a mal-united calcaneal fracture with or without sub-talar intra-articular involvement. Almost every patient had ballooned out body of calcaneum with impingement of peroneal tendon sheath with its content and lateral heel pain as a result of deformity. So in current study the operative procedure selected was excision of a lateral calcaneal bony mass and decompression of the peroneal tendon to relieve pain. Peroneal tenogram was a routine procedure before surgery to detect presence and site of blockade within tendon sheath. The average follow-up was for a period of 31.6 months. Result was assessed according to American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hind foot Scale. Two patients (n=2, 8.69%) had excellent (Category 1) result, seventeen (n=17, 73.9%) were good (Category 2), two (n=2, 8.69%) were fair (Category 3) and rest two (n=2, 8.69%) were with poor (Category 4) outcome. Every four out of five patients got back painless Heel and Ankle after surgery. The results suggest that the lateral decompression procedure is a technically simpler yet viable alternative to late sub-talar fusion for lateral pain following a mal-united fracture of calcaneum.
authors: Department of Orthopaedics, Kolkata Medical College, Kolkata, West Bengal, India. orthoarunangsu@yahoo.com
authors: A
authors: A
authors: Bhattacharyya
authors: R
authors: R
authors: Raman
mesh_terms: D000328:Adult; D002111:Calcaneus / Q000293:injuries*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D017759:Fractures, Malunited / Q000601:surgery*; D006365:Heel / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013710:Tendons / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult