Abstract
Backgroud: Calcaneum is the most commonly fractured tarsal bone. Approximately 75% are intra-articular fractures. Controversy continues regarding the management of calcaneal fractures. Earlier conservative management was preferred and surgical management considered inappropriate for these fractures. This trend is gradually changing with better understanding of disabling nature of injuries in combination with improved implant and routine use of intra-operative imaging. Closed treatment with cast invariably leads to long-term complications. However, still clinical evidence supporting operative treatment is limited and complications are frequently documented. Objectives: To evaluate the functional outcome of intraarticular fractures of calcaneum in terms of American Orthopaedic Foot and Ankle Society (AOFAS) score and Visual Analogue Scale (VAS) score. Methods: This study was a retrospective analytic study. The study was conducted in the Department of Orthopaedics, B.P. Koirala Institute of Health Sciences, Nepal. Data collection and analysis of patients operated from July 2017 to June 2019 was done. Twenty six cases that fulfilled inclusion criteria were analysed. Results: Average age of the patients was 32 years. Sanders type 2B was the most common fracture pattern. There was significant improvement in Bohler angle (25.1°), calcaneal height (4.3cm) and width (3.9cm). Average AOFAS score and VAS score at final follow up were 81.4 and 7.9 respectively. Conclusion: Open reduction and internal fixation with plate is associated with good clinical and functional outcome in Sander type II and III fractures. With good surgical techniques, improved implant and proper use of fluoroscopy, proper restoration of Bohler angle, calcaneal height and width can be achieved.
Key words: Calcaneum, Intraarticular fracture, Outcome, Plate.