Outcome analysis of displaced intraarticular calcaneal fracturesA case series
|IJOCP | Volume – 2015| Issue – 2015| Article ID – 2015:88
Conference: Indian Orthopaedic Association Annual Conference IOACON-2013, India [Click for Full details]
Authors: Ponnusamy S, Rajasekar M R
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Purpose: This is a prospective clinical study to outline the functional, clinical and radiological results in 25 patients treated with polytail/tentacular plates for displaced/comminuted calcaneal fractures in our institute.
Methods: Mean age of the patients was 32.2 years. Majority of them were male – 76% with history of accidental fall from height predominate the series by 72% .Sanders classification was followed, of which 8 were type II,11 were type III and 6 were type IV. Mean o o o Bohler’s angle was 14.6 (range – 10 to 22 ). Preoperative CT scan with 3D reconstruction was taken in all cases. Mean interval for surgery is 15 days. According to the fracture pattern and comminution, number and positioning of the screws, bone graft to be used or not, were planned. We did bone grafting in 14 cases (56%). Extensile lateral approach was used for all cases and thick flap was raised along with incision to avoid the common wound problems.
Results: Regular follow up of all patients were done with subjective, clinical and radiological assessment (mean follow up of 18 months). At the end of 3rd month, normal weight bearing is allowed. Scars had a satisfactory healing in 88% of cases. Ankle movements were identical to the opposite foot in 92% of cases while remaining 8% had ankle movement restriction. Post o o operatively Bohler’s angle was corrected to 20 -30 in o o 84% of cases and 15 -20 in 16% of cases. (Averageo 24.56 ). Mean pre-op calcaneal height was 38.6 mm which was corrected to an average of 49.64 mm. Subtalar joint congruence, calcaneo – cuboid reduction were achieved in 76% of the cases and the remaining 24% of cases had subtalar joint incongruency. In our series, 6 cases developed subtalar joint restriction, 3 cases (12%) had wound dehiscence, 2 cases had ankle joint restriction, 1 case (4%) had osteomyelitis, 1 case (4%) had implant loosening. Radiological union obtained in 96% of the cases (24 cases). 95% of the patients resumed their work after 6 to 11 months. Among 25 patients operated, 14 patients were very much satisfied, 10 were satisfied & 1 had a poor result.
Conclusion: Proper pre-operative planning, rigid fixation with calcaneal tentacle plate and adequate screws through extensile lateral approach, anatomical reduction to achieve subtalar joint congruency, using bone grafts in comminuted fractures, early post op rehabilitation, delayed weight bearing will give good results in case of displaced intra articular calcaneal fractures.
|How to Cite this Abstract|
|Ponnusamy S, Rajasekar M R . Outcome analysis of displaced intraarticular calcaneal fracturesA case series. International Journal of Conference Proceedings 2015;(2015):88|