A prospective study of the functional outcomes in operative management of intra-articular <i>Calcaneum</i> fractures

Abstract

Background & Objectives: The treatment of intra-articular fractures of the calcaneum remains controversial. There is no consensus in the current literature regarding the optimal treatment of intra-articular fractures of the calcaneum. In the current prospective study, we intend to study the outcome of operative management for intra-articular calcaneum fractures based on the objective criteria, that is, restoration of Bohler’s angle, subtalar range of motion and subjective criteria such as pain, return to work, return to physical activity, change in shoe wear.Materials and Method Design Prospective study: Study was conducted in St Martha’s Hospital, Bangalore, during the period extending from Nov’2014 to Dec’2016. 15 patients with 17 intra-articular calcaneum fracture were included in the study. Outcome of operative management was evaluated using Modified Rowes scoring system. Pretreatment and post treatment (at follow up) Bohler’s angle and Gissane’s angle was also compared. Chi-square analysis and student ‘t’ test was done to analyze the results of operative management. Results: Restoration of the Bohler’s angle was achieved with operative management. Functional outcome for type I and II fractures was better than with type III and IV. A significant correlation was seen between the post-operative Bohler’s angle and Rowe scores. Interpretation & Conclusion: Operative management has a good to fair functional outcome for displaced calcaneal fractures. For displaced and comminuted fractures anatomical reduction and restoration of Bohler’s angle is very important. Bohler’s angle has a prognostic importance and correlates well with the functional outcome.