Operative versus non operative treatment for displaced intra articular fracture of calcaneus: A prospective study 58 patients

Abstract

Background: Calcaneus fractures are the most common tarsal bone fractures, and displaced intra articular fractures account for 60% to &75% of all calcaneal fractures. Fractures of the calcaneus remain among the most challenging for the orthopedic surgeon to manage effectively as these injuries are more destructing and devastating. The management dilemma is still going on regarding conservative or operative treatment for such fractures as there is no clear evidence to delineate the gold standard treatment method, which is superior in every aspect. Material and Method: We have done a prospective study of 58 patients (2 had bilateral fracture) with displaced intra-articular calcaneus fracture after applying strict inclusion and exclusion criteria. We have randomly allocated patients into operative (A, n-30) and non-operative groups (B, n-30). We compared the clinical, functional and radiological outcomes of both groups. Results: The mean age in the operative group is 34.7 years and in the non-operative group is 36.03 years. The average follow-up is 12.4 months and the average time of union was 10.1 weeks in the operative group, while in a non-operative group it is 11.03 month and 10.6 weeks, respectively. The mean AOFAS score at the final follow up of the operative group is 84.2 and in the other group it is 79.4. Total of 8(39%) patients undergoing operative management have an excellent result, 15(50%) have good results,3(10%) have fair and 4(1%) have poor results as compared to the other group 4 (13%), 9 (30%), 8(27%), 9(30%) respectively. Conclusion: Operative management has a better radiological, clinical and functional score in comparison with conservatively managed patients of displaced intra articular calcaneal fracture. However, operative management is also associated with an increased number of surgery-related complications like long hospital stay, cost effectiveness, local wound healing problems, superficial and deep infection, implant related problems as compared to another group.