J Korean Orthop Assoc.  2017 Feb;52(1):49-58. 10.4055/jkoa.2017.52.1.49.

Comparative Study of Open Reduction and Internal Fixation and Primary Subtalar Arthrodesis for Sanders Type 4 Intra-Articular Calcaneal Fractures

• Woo SH
• Chung HJ
• Bae SY
• Kim SK

• KMID: 2369571
• DOI: http://doi.org/10.4055/jkoa.2017.52.1.49

Abstract

PURPOSE
To compare clinical outcome of Sanders type IV intra-articular calcaneal fracture treated with open reduction and internal fixation (ORIF) versus ORIF and primary subtalar arthrodesis (PSTA).
MATERIALS AND METHODS
Between March 2003 and November 2013, 22 patients with 22 Sanders type 4 intra-articular calcaneal fractures were included in this study. Of these, 11 were treated with ORIF (ORIF group), and 11 were treated with ORIF and PSTA (PSTA group). The mean follow-up period was 34.6 months (range, 18-72 months). Clinical outcomes were assessed along with the American Orthopedic Foot and Ankle Society's ankle-hindfoot scale (AOFAS score), and the visual analogue scale pain score (VAS score) at 6-month, 12-month, and last follow-up. Patient satisfaction, return to previous occupation and postoperative complications were also investigated.
RESULTS
The results for ORIF did not differ from those for PSTA based on the last follow-up AOFAS scores or the VAS scores (p>0.05). However, patient satisfaction was significantly higher in the PSTA group (p=0.008). Secondary subtalar arthrodesis was conducted in five patients (45.5%) of the ORIF group within 2 years postoperatively.
CONCLUSION
We were unable to demonstrate a significant difference in clinical outcomes between ORIF and PSTA; however, the patient satisfaction was higher in the PSTA group. PSTA may be a suitable choice for patients who need fast recovery to daily activity and to prevent the need for secondary subtalar arthrodesis.

Keyword

calcaneus fracure; open reduction and internal fixation; arthrodesis

MeSH Terms

Ankle
Arthrodesis*
Follow-Up Studies
Foot
Humans
Occupations
Orthopedics
Patient Satisfaction
Postoperative Complications

Figure

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  Figure 1 Clinical outcome results of complete study group. ORIF, open reduction and internal fixation; PSTA, primary subtalar arthrodesis; AOFAS, American Orthopedic Foot and Ankle Society; Last FU, last follow-up; VAS, visual analogue scale.

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  Figure 2 Clinical outcome results of secondary subtalar arthrodesis and primary subtalar arthrodesis. SSTA, secondary subtalar arthrodesis; PSTA, primary subtalar arthrodesis; AOFAS, American Orthopedic Foot and Ankle Society; Last FU, last follow-up; VAS, visual analogue scale.

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