journal of medical science and clinical research | 2019
Funcutional Outcome of Intra-Articular Joint Depressed Fractures of Calcaneum Treated by Lateral Plating- A Case Series of 35 Patients Followed For an Average Duration of 24 Months
Abstract
1 MS (Ortho), 2 S.R. (Dept. of Orthopaedics) Maharshi Vashishtha Autonomous State Medical College, Basti 3 Associate Professor and HOD (Dept. of Orthopaedic), Maharshi Vashishtha Autonomous State Medical College, Basti 4 Associate Professor, M.L.B. Medical College, Jhansi *Corresponding Author Dr Ranjeet Kumar Patel S.R. (Dept. of Orthopaedics), Maharshi Vashishtha Autonomous State Medical College, Basti Abstract Background: There is no consensus as to which is the best treatment for intraarticular fractures of the calcaneus. Many people treat it conservatively whereas many go for operative procedures. Even for surgical treatment many do it by percutaneous technique many go for open reduction and internal fixation with plate or cancellous screws. Purpose: To present a case series of 35 patients with intra-articular joint depressed fractures of calcaneum treated by open reduction and internal fixation with plate through a lateral approach. Material and Methods: A retrospective study was done in a level 1 trauma centre in which 35 patients (29 males and 6 females)of joint depressed type of calcaneum fractures were treated by open reduction and fixation by plate. All had acute trauma. Based on 2-dimensional CT scans, the fractures were categorized using Sanders classification. Radiographs and Maryland foot scores were used for evaluation of the results. Average follow-up was 24 months. Results: 30 patients had full sub-talar range of movement and 5 patients had restricted range of movement. 11 of 12 patients returned to manual labour jobs, the others were not employed at the time of injury. 26 patients had an excellent Maryland foot score and 9 patients had agood score . Interpretation: Intra-articular calcaneum fractures are associated with high chances of sub-talar arthritis with loss of sub-talar movement if not treated properly. Reduction of posterior facet is more important in joint depressed type of fracture. Lateral plating for these complicated fractures resulted in good to excellent sub-talar joint function with restoration of heel height, width and normal heel valgus. Keyword: Intra-articular calcaneum fractures, trauma, plate, treatment outcome.