title: Complications in operative fixation of calcaneal fractures.
abstract: OBJECTIVE
  The purpose of this study focused on a number of factors that have been implicated in calcaneal complications and find the incidence of wound complications.
  
  
  METHODS
  This was a retrospective study. A total of 162 patients (176 feet) who underwent calcaneal fractures between 2007 and 2012 were included. The patient's personal details, age, time from injury to surgery, cause of injury, type of fracture, operative details, operating and tourniquet times were collected from hospital computers and paper records. Evidence of complications including wound infection, wound necrosis, pain, malunion, nonunion, impingement, loss of fixation, ect were studied.
  
  
  RESULTS
  Forty-seven of one hundred and seventy-six fractures (26.704%) had complications, wound infection was noted in seven fractures (3.977%), twelve fractures developed necrosis (6.818%), 14 fractures (7.955%) developed pain. Malunion was found in five fractures (2.841%), nonunion in two fractures (1.136%) and loss of fixation in four fractures (2.272%). Three neurologic injury was also seen in our study (1.705%). Operating time, time from injury to surgery and type of fracture had some association with complications in operative fixation of calcaneal fractures, which showed a statistically significant improvement (P=0.000, 0.031, 0.020, respectively), but there were no evidence that age and tourniquet time affect the incidence of complication after calcaneal fracture surgery (P=0.119, 0.682, respectively).
  
  
  CONCLUSIONS
  Despite developments in the surgical treatment of calcaneal fracture, wound complications still remain inevitable. Advanced imaging techniques, less invasive surgical procedures, wealth of anatomical knowledge, surgical experience and better postoperative care should be ensured.
authors.affiliation: Ying Li, Department of Orthopaedics, Guangdong Hospital of Integrated Traditional and Western Medicine, Foshan 528200, Guangdong, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Rong-Hua Bao, Department of Orthopaedics, Orthopedics Hospital of Traditional Chinese Medicine of Fuyang, Hangzhou 311400, Zhejiang, China.
authors.forename: Rong-Hua
authors.initials: RH
authors.lastname: Bao
authors.affiliation: Zhi-Qiang Jiang, Department of Orthopaedics, Guangdong Hospital of Integrated Traditional and Western Medicine, Foshan 528200, Guangdong, China.
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Jiang
authors.affiliation: Huo-Yan Wu, Department of Orthopaedics, Guangdong Hospital of Integrated Traditional and Western Medicine, Foshan 528200, Guangdong, China.
authors.forename: Huo-Yan
authors.initials: HY
authors.lastname: Wu
keywords: Associated factors; Calcaneal fractures; Complication; Management