title: Need for Bone Grafts in the Surgical Treatment of Displaced Intra-Articular Calcaneal Fractures.
abstract: Controversy is ongoing regarding the use of bone grafts to fill cavities that occur with collapse of the posterior facet in the joint and for repair of the calcaneal height with plating. The present study included 40 patients with 43 displaced intra-articular calcaneal fractures treated with open reduction and internal fixation from March 2009 to November 2013. In the present case-control study, the patients were separated into 2 groups: group A received an allograft (20 patients, 22 calcaneal fractures) and group B did not (20 patients, 21 calcaneal fractures). The calcaneal height and Böhler's angle were compared between the 2 groups. The final outcomes for all patients were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot scale score and compared between the 2 groups. No significant differences were observed between the groups with regard to the basic demographic variables (p > .05). Using Sanders classification, 8 (18%) were type 2, 19 (44%) were type 3, and 16 (37%) were type 4 fractures. The comparisons between the 2 groups showed a loss of Böhler's angle and loss of calcaneal height that was significantly greater in group B (p < .001). No significant differences were observed between the 2 groups in the AOFAS ankle hindfoot scale scores (p > .05). In conclusion, although no differences were found in the clinical results between the 2 groups, more satisfactory radiologic results were obtained in group A, in which bone grafts were used.
authors.affiliation: Orthopedist, Department of Orthopaedics, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Tahir Mutlu
authors.initials: TM
authors.lastname: Duymus
authors.affiliation: Assistant Professor, Department of Orthopaedics, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey. Electronic address: drserhatmutlu@yahoo.com.
authors.forename: Serhat
authors.initials: S
authors.lastname: Mutlu
authors.affiliation: Orthopedist, Department of Orthopaedics, Taksim Training and Research Hospital, Istanbul, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Mutlu
authors.affiliation: Orthopedist, Department of Orthopaedics, Istanbul Baskent University Hospital, Istanbul, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Ozel
authors.affiliation: Assistant Professor, Department of Orthopaedics, Istanbul Medipol University Hospital, Istanbul, Turkey.
authors.forename: Olcay
authors.initials: O
authors.lastname: Guler
authors.affiliation: Professor, Department of Orthopaedics, Istanbul Medipol University Hospital, Istanbul, Turkey.
authors.forename: Mahir
authors.initials: M
authors.lastname: Mahirogullari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064386:Ankle Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D016025:Bone Transplantation / Q000379:methods*; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D007593:Joint Instability / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011859:Radiography / Q000379:methods; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
keywords: Böhler's angle; Sander's classification; allograft; calcaneus; subtalar joint; trauma