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INTRA-ARTICULAR FRACTURES OF THE CALCANEUS: SHOULD WE BE OPERATING ON THEM ?



Abstract

Controversy exists regarding the management of intra-articular fractures of the calcaneus. We present medium-term outcome data on 37 consecutive patients who underwent open reduction and internal fixation for comminuted intra-articular calcaneal fractures.

Operations were performed by one surgeon, CRW, following CT assessment of the fracture. All procedures were performed using an extensile lateral approach and early physiotherapy was standard. Case notes were reviewed retrospectively between three months and five years post-operatively. Patients were also invited to attend a follow-up clinic where outcomes were assessed using the American Orthopaedic Foot and Ankle Society Hind Foot Score and were questioned regarding on-going problems, change in shoe size and return to work.

Complete data is available for 16 patients, with additional information from other patients. Results show average AOFAS scores for type II fractures to be 59/100, type III to be 81/100 and 79/100 for type IV fractures. We have shown low rates of complications – one infection, three patients requiring a change in shoe size and an average return to work of seven months.

We have shown good medium-term outcome results for the operative management of displaced intra-articular fractures and to answer our question, we believe we should be operating on them.

The abstracts were prepared by Mr J. L. Barrie. Correspondence should be addressed to Mr J. L. Barrie, BOFSS Editor, Department of Orthopaedic Surgery, Blackburn Royal Infirmary, Blackburn, Lancashire BB2 3LR.