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LONG TERM RESULTS OF CONSERVATIVE TREATMENT FOR CALCANEAL INTRAARTICULAR FRACTURES.



Abstract

The purpose of this study was to present the long team functional results after conservative treatment of intraarticular calcaneal fractures. Nine patients with 11 fractures (mean age at accident 52 years old) were reevaluated. Mean follow-up was 8 years (6–15). 5 fractures were tongue type, 5 were compression fractures and 1 with comminution according to Essex Lopresti classification. These patients were clinically and functionally evaluated with the Ankle-Hind foot scale (Kitaoka, 1994). They were submitted to radiographic testing (foot AP, ankle lateral, axial and medial axial views). Osteoarthritic (OA) changes, calcaneal dimensions (height, width) and Bohler’s – Gissane’s angles were recorded.

According to Ankle Hind foot score (highest 100) our patients scored a mean 77 points (48–90). OA changes were recorded in 7 cases in the ankle joint and in all cases in taloscaphoid, calcanocuboid (severe in 8) and subtalar joints (severe in 5). We found width reduction in 6 patients and height reduction in 2, compared to the healthy side. Bohler’s angle was abnormal in 6 cases (−21°to 52°) while Gissane’s angle was abnormal in 9 (84° to 115°).

Treatment of intraarticular calcaneal fractures is still controversial. Recent studies show a tendency for surgical treatment. In the present study a distinction between clinical and radiographic findings was made. Patients had satisfactory functional results although severe osteoarthritic changes were recorded.

Correspondence should be addressed to 8 Martiou Str. Panorama, Thessaloniki PC:55236, Greece.