Article ID Journal Published Year Pages File Type
4055249 Foot and Ankle Surgery 2006 9 Pages PDF
Abstract

Osteosynthesis for calcaneal fractures remains controversial. We osteosynthesize all displaced intraarticular fractures, the only contraindications regarding age, local and arterial status, or non-compliance. We here report a prospective study of 31 calcaneal articular fractures, with a mean 4.5 years follow-up.Following CT scan, patients were operated at a mean 6.1 days with the same surgical (single surgeon-extended lateral approach) and post-operative protocol. On Sanders' classification, there were 18 type II, 8 type III, and 5 type IV fractures. Twenty-six patients had clinical and comparative standard X-ray follow-up; 19 also had CT assessment.Two complications needed repeat surgery: one limited skin necrosis, one infected hematoma. Fifty-eight % were very satisfied, and 42% satisfied; 77% returned to work. Mean Kitaoka score was 86.2. Tibiotarsal motion was normal, and subtalar motion 45%. X-ray confirmed anatomical reconstruction: no joint reduction defect; medial arch angle, calcaneal pitch, calcaneal soft-pad thickness, and calcaneus height, length and width subnormal. Mean Boehler angles were: 6.6° preoperatively, 32.3° postoperatively, and 27.1° on follow-up for injured vs. 32° for non-injured foot. Thirty-six % had posterior subtalar remodeling on standard X-ray, and 79% on CT scan, without correlation with functional results or radiological type.Due to calcaneal posterior facet height loss, we recommend 10 weeks' non-weightbearing. These good results match the literature, generally indicating surgery for displaced calcaneal intraarticular fractures.

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