title: A Prospective Study on Radiological and Functional Outcome of Displaced Tongue Type Intra-Articular Calcaneal Fractures Treated by Percutaneous Screw Fixation.
abstract: BACKGROUND
  Calcaneal fractures have posed a challenge to orthopaedic surgeon for many years. The major problem is to reconstruct the fracture and improve healing of the fracture and also the surrounding tissues. Anatomic restoration of the three-dimensional anatomy of the calcaneum is the goal of surgical management of calcaneal fractures. Over the years, various techniques have been developed to accomplish this goal.
  
  
  OBJECTIVE
  To determine the functional outcome in displaced tongue-type calcaneal fracture treated by percutaneous screw fixation.
  
  
  METHODS
  A prospective study was conducted from October 2012 and September 2014. A total of 23 patients with intra-articular 'tongue type' calcaneal fractures were included in the study. Complete clinical and radiological evaluation was done. The surgical procedure encompassed closed reduction and fixation with two criss-cross 6.5 mm cannulated cancellous across the fracture site under fluoroscopic guidance. Postoperatively, on day three ankle and toe mobilization was begun. Non-weight bearing crutch mobilization was begun on postoperative day three. Reviews were done at 6 weeks, 12 weeks and 24 weeks postoperatively. At 6 weeks partial weight bearing mobilization was started. Full weight bearing was begun at 12 weeks. The patient was finally reviewed at 24 weeks and assessment of ankle function was done as per the Maryland foot scoring system. Radiographs were compared and preoperative and postoperative Gissane's and Bohler's angles were also compared. The results were analysed as per descriptive statistics (frequency, percentage). The complications noted were documented.
  
  
  RESULTS
  Of the 23 patients under the study, three had excellent results with mean score of 90, 17 had good results with mean score of 82.94 and three had fair results with mean score of 74. Only one patient had subtalar arthritis as a complication. No other complications were seen.
  
  
  CONCLUSIONS
  Percutaneous screw fixation of tongue type calcaneal fractures is a very effective surgical technique.
authors.affiliation: Registrar, Department of Orthopaedic Surgery, ARS Hospital Tirupur, Tamil Nadu, India .
authors.forename: Anoop
authors.initials: A
authors.lastname: Hegde
authors.affiliation: Professor, Department of Orthopaedic Surgery, K.S. Hegde Medical Academy , Deralakatte, Mangalore, India .
authors.forename: Lawrence John
authors.initials: LJ
authors.lastname: Mathias
authors.affiliation: Registrar, Department of Orthopaedic Surgery, ARS Hospital Tirupur, Tamil Nadu, India .
authors.forename: Arjun
authors.initials: A
authors.lastname: Ballal
authors.affiliation: Associate Professor, Department of Orthopaedic Surgery, K.S. Hegde Medical Academy , Deralakatte, Mangalore, India .
authors.forename: Vikram
authors.initials: V
authors.lastname: Shetty
authors.affiliation: Associate Professor, Department of Orthopaedic Surgery, K.S. Hegde Medical Academy , Deralakatte, Mangalore, India .
authors.forename: Ashwin
authors.initials: A
authors.lastname: Shetty
keywords: Calcaneum; Essex lopresti; Joint depression type