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General Orthopaedics

OPEN REDUCTION AND INTERNAL FIXATION IN TYPE II AND III FRACTURES OF THE CALCANEUM

The Indian Orthopaedic Society (UK) (IOSUK)



Abstract

Background

Outcome of Type II and III (Sander's CT classification) fracture of the calcaneum who underwent open reduction and internal fixation was assessed.

Methods

Thirty-three type II and III fractures of the calcaneum (all unilateral) underwent open reduction and internal fixation using the ‘extensile lateral approach’. There were twelve Type II and twenty-one Type III fractures. Patients were followed up for a mean of 40.81 months (Range 28 to 62 months). Patients were assessed clinically by the Creighton Nebraska Health foundation score for assessment of fractures of the calcaneum. Radiologically assessment was done comparing the pre and post operativeBohler's and Gissane angles and measuring the calcaneal width on the axial xrays.

Results

Nineteen patient were classified as excellent and 14 as good. There were no poor or fair results. The mean correction of Bohler's angle was 5.6 +/− 7.2 and the Gissane'sanglecorrected by 7.8 +/−5.8 °. Superficial skin necrosis was the most common complication encountered (3 patients). Two patients preferred removal of the implant after fracture union due to prominent hardware.

Conclusion

Open reduction Type II and III intra – articular calcaneal fractures is associated with minimal complications and gives reproducible results, especially in young adults