Open reduction and internal fixation of displaced intra-articular calcaneal fractures

ABSTRACT

Twenty- six patients with 29 closed displaced intra-articular calcaneal fractures were treated by open reduction and internal fixation at Tanta University Hospital in the period from July 2001 till October 2003. Sixteen patients were males and ten were females. The age ranged from 20 to 45 years with an average of 33 year. The fractures were classified according to Sanders' classification into type II in 7 fractures, type III in 13 fractures, and type IV in 9 fractures. Internal fixation was performed using interfragmentary screws and specific plates for calcaneal fractures. The follow up period ranged from 7 to 20 months with an average of 10 months. The functional outcome was satisfactory in 20 fractures and unsatisfactory in 9 fractures. The complications met with were sural nerve injury in two cases, delayed wound healing in one case, broadening of the heel in one case, mal-reduction with residual varus deformity in two cases, peroneal tendinitis in four eases, deep infection in one case and sudek's atrophy in two cases. The advantages of this surgical interference were restoration of the congruity and height of the nearby joints, in addition to decompression of the lateral structures to prevent the development of impingement syndrome. Also if arthrodesis will be needed later on, it would be done on a near anatomical position