Operative treatment for displaced intra-articular calcaneal fractures

【Objective】 To explore the operative methods with open reduction and internal fixation and evaluate the clinical effect of the displaced intra-articular calcaneal fractures.【Methods】 There were 34 fractures of the calcaneus treated in 29 patients who were treated with open reduction and internal fixation from August 2005 to February 2008.Fracture classification was based on Sanders classification including 25 type Ⅱ fractures,6 type Ⅲ fractures and 3 type fractures.Extended lateral approach or medial approach assistantly,and fixed the fractures with plate and screw for calcaneus were performed.Bone graft was used in 8 cases.【Results】 All the patients were followed up,and average follow-up was 15.6 months(range from 9 to 24 months).Evaluated using radiographic examinations,average calcaneal Bhler′s angle was(4.5±0.7)° preoperatively and(26.6±1.8)° postperatively,and calcaneal Gissane angle was(91.0±5.6)° preoperatively and(126.0±4.5)° postperatively.The evaluation of the results by Maryland Foot Sorce for displaced intra-articular fractures of the calcaneus showed that the average score was 86 for type Ⅱ fractures,and 75 for type Ⅲ fractures and 54 for type Ⅳ fractures.Excellent or good clinical results occurred in 84% type Ⅱ fractures,67% type Ⅲ fractures and 33% type Ⅳ fractures.The overall excellent or good rate was 76%.【Conclusion】 Operative treatment with open reduction and internal fixation for the displaced intra-articular calcaneal fractures is recommended,especially for Sanders typeⅡ and type Ⅲ fractures.