Treatment of displaced intra-articular calcaneal fractures by open reduction and internal fixation

Objective To make a retrospective analysis of the outcome and prognosis of open reduction and internal fixation in the treatment of displaced intra-articular calcaneal fractures.Methods From January 2007 to January 2010,38 patients with displaced intra-articular calcaneal fractures treated by open reduction and plates fixation were identified.24 of males and 14 of females patients were included in this study.All patients had special plates fixation through a lateral approach.All cases were followed up for at least 2 years,with radiologic check-up by X-ray and CT imaging.Clinical results were evaluated by American orthopedic foot and ankle society hindfoot scale(AOFAS),foot function index(FFI),10-scale visual analogue scores(VAS).Results A total of 38 patients were included,consisting of 17 of sanders type Ⅱ and 21 of sanders type Ⅲ fractures.Preoperative Bohler′s angle was-24°-33°,with an average of(13.2±8.9)°,which recovered to 20°-45°,with an average of(33.8±9.2)°.No significant difference was found between groups based on sanders type or age(all P 0.05),however,better results were obtained in anatomic reduction and iliac autografts group for AOFAS,FFI and VAS,as compared with patients who did not have anatomic reduction or iliac autograft(all P 0.05).Conclusion The results of this study demonstrate that mid-term prognosis of displaced intra-articular calcaneal fracture is correlated significantly with individual features of cases,degree of anatomic reduction of subtalar joint and recovery of Bohler′s angle,while no correlation with sex and fractures type.