Open Reduction of Displaced Intra - Articular Fractures of the Calcaneus

Park, Myung Sik; Kim, Jung Sik

Abstract

Many different methods have tried for the treatment of fractures of the calcaneus in order to search for better results. But there was no general agreement on the treatment of the fracture of the calcaneus, especially involving the subtalar joint. Thirteen displaced intra-articular fractures of the calcaneus(in eleven patients) were treated by open reduction and internal fixation with a plate and screws, or Steinmann pins using a lateral and when needed, a medial approach, followed by early motion. From Feb. 1985 to June 1987, 13 feet in 11 patients of calcaneal fractures involving the subtalar joint were treated by open reduction and internal fixation at the Dept. of Orthopedic Surg., Chonbuk National University Hospital and the results were ss follows : l. Of 11 patients, 9 patients were male and 2 were femsle. 2. The main cause of frscture of calcaneus wss a fall from a height in 81.8% of cases. The spine fractures were associsted in 3 patients. 3. Of these displaced intra-articular frsctures, 3 fractures were tongue type and 9 fractures were joint depression type by Essex-Lopresti classificstion. 4. The tongue type fractures were treated with Steinmann pin and joint depression type fractures were treated with plate and screws. Anatomic reduction was obtained by open reduction snd internal fixation. 5. The average Bohler's angle was 8.1 before reduction and the aversge bohler's angle was 22.1 after open reduction. So, Bohler's angle was 14 increased. 6. After sverage seventy-two months follow-up, the assessment of result by Salama was satisfied in 76.9%-excellent in four(30.8%), good in six(46.1%)-and unsatisfied in 23.1%-fair in two(15.4%), poor in one(17.7%). 7. The surgical approach was used usually lateral approach and, when needed, a medial approach, followed by early motion. 8. The most common complication after treatment was pain on the heel snd subtalar joint.