title: Primary fusion in worker's compensation intraarticular calcaneus fracture. Prospective study of 169 consecutive cases.
abstract: OBJECTIVE
  To study the results of reconstruction and primary fusion in worker's compensation intraarticular calcaneus fractures.
  
  
  METHODS
  We carried out a prospective study of 169 acute intraarticular calcaneus fractures treated by reconstruction and primary fusion with the minimally invasive Vira® system, in severe calcaneus fractures. The evaluation was performed by clinical, radiological and biomechanical analysis.
  
  
  RESULTS
  AOFAS score averaged 77.26 points at the end of follow up. Forty-two cases (24.9%) obtained excellent results, 108 (63.9%) good, 12 (7.1%) mild and 7 (4.1%) poor. The improvement in Börder's angle after surgery was significant (p = 0.05) and this did not vary during the follow up. Subtalar arthrodesis was achieved in all cases and only three cases needed bone grafting. Five major post-surgical complications were observed, and one deep infection in a case of open Gustilo Grade III fracture. In the kinetic study, the support time of the operated foot was lower than that of the contralateral foot (p<0.21). The axial force of the heel contact and the single limb support of the operated foot reduced the toe-off axial forces. In the foot with arthrodesis the posterior forces increased (p <0.01). The pressures were lower in the region of the heel and the mid-foot and in the external part of the forefoot, and increased in the big toe.
  
  
  CONCLUSIONS
  Calcaneal workplace injuries are challenging to treat. Primary subtalar fusion with a minimally invasive method allows rapid recovery for these patients with a satisfactory clinical, functional and radiological outcome.
authors.affiliation: Department of Orthopaedic Surgery, Fundación Jiménez Diaz, Madrid, Spain. flopezoliva@hotmail.es
authors.forename: Felipe
authors.initials: F
authors.lastname: López-Oliva
authors.forename: Tomás
authors.initials: T
authors.lastname: Sánchez-Lorente
authors.forename: Adela
authors.initials: A
authors.lastname: Fuentes-Sanz
authors.forename: Francisco
authors.initials: F
authors.lastname: Forriol
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Aldomar-Sanz
mesh_terms: D000062:Accidents, Occupational / Q000191:economics / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D001174:Arthrodesis / Q000191:economics / Q000379:methods*; D001696:Biomechanical Phenomena; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000191:economics / Q000379:methods*; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000191:economics / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D013030:Spain; D016896:Treatment Outcome; D014942:Workers' Compensation