title: Functional outcome following a locked fracture-dislocation of the calcaneus.
abstract: Locked fracture-dislocations of the calcaneus are uncommon, and a substantial number of these injuries is not recognised or is misdiagnosed at first presentation. The primary aim of this study was to evaluate the long-term outcome in patients with this injury.
  
  
  
  This is a retrospective cohort study of adult patients who sustained a uni- or bilateral calcaneal fracturedislocation. Outcome was measured using validated questionnaires, including the American Orthopaedic Foot and Ankle Society Hindfoot score (AOFAS), Foot Function Index (FFI) and a visual analogue scale (VAS).
  
  
  
  During the 12-year study period a total of 16 patients with 17 locked fracture-dislocations were identified. This represented 6 % of all surgically treated calcaneal fractures (17 of 279). The median follow-up was 48 months. All patients were treated using an extended lateral approach and plate fixation. In one patient with a delayed presentation a primary arthrodesis was performed. The functional outcome scores were available for 14 patients with 14 fractures. The median AOFAS was 74 [interquartile range (IQR) 47–86], the median FFI was 18 (IQR 6–37) and the median VAS for overall satisfactionwas 8.2 (IQR 5.5–9.4). A secondary fusion was deemed necessary in three cases.
  
  
  
  This study shows that, with surgical treatment via an extended lateral approach, the outcome in patients with a locked fracture-dislocation of the calcaneus is similar to the outcome of other displaced intra-articular calcaneal fracture types. However, a higher rate of secondary subtalar fusion can be expected.
authors: Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. t.schepers@amc.nl
authors: Tim
authors: T
authors: Schepers
authors: Manouk
authors: M
authors: Backes
authors: Niels W  L
authors: NW
authors: Schep
authors: J Carel
authors: JC
authors: Goslings
authors: Jan S K
authors: JS
authors: Luitse
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D013380:Subtalar Joint / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
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