Operative treatment of articular calcaneal fractures
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2007, Vol 9, Issue 1
Abstract
Introduction: although pioneers such as Leriche in 1921 and Judet in 1954 introduced screw or plate fixation of the broken calcaneus, surgical treatment using open anatomical reduction and stable internal osteosynthesis only commenced at the start of the 1980s. This treatment was made possible by the introduction of new imaging methods such as CT which allowed better detection of the fracture pathology and provided the basis for new surgical strategies like the anatomically shaped calcaneal plates available since the early 1990s. Material and methods: during a 3-year period (2002-2005) the authors treated operatively 23 (in 19 men and 4 women, aged 19-57) dislocated calcaneal fractures involving the posterior calcaneo-talar joint (Sanders II i III according to CT based classification). The therapy involved open reduction and internal fixation of the calcaneus through an extended lateral approach. Fixation was performed with the use of lag screws and a reconstruction plate. We described the anatomic (evaluation of the posterior articular surface of the calcaneus and of the Bohler angle) and functional results using the Creighton-Nebraska system. Results: in this prospectively evaluated group we achieved 12 good and 11 very good anatomic results, and 2 fair, 16 good and 5 very good functional results, after at least a year since the operation. Infection was noted in 3 patients. Conclusions: the therapeutic option described above requires careful preoperative planning with evaluation of the fracture pattern and patient condition, good surgical expertise and allows achievement of good moderate term (1-3 years) results. The presence of a good or very good reduction does not universally match the functional outcome.
Authors and Affiliations
Paweł Grala, Zofia Machyńska-Bućko, Grzegorz Kierzynka
Keywords
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