Functional outcome of calcaneal fractures treated either conservatively or operatively; a comparative study

ABSTRACT

The aim of this paper is to compare the functional results of treatment of displaced intracalcaneal fractures after operative and conservative management. Thirty seven patients with 42 feet having displaced intra-articular calcaneal fractures were included in this study. These were divided into two groups. Cases in group I were treated by open reduction and internal fixation, while those in group II were treated conservatively. In both groups, the injury was common in males, in the 3rd and 4th decades of life. Most of them were heavy manual workers. Falling from a height was the commonest mode of injury. All patients were assessed by stndard plain radiographs and CT scans. In group I, surgery was done after an average of 4.3 days. The extended lateral approach was used with calcaneal or 3.5mm reconstruction plates. In group II, intensive rehabilitation program started as soon as pain and swelling allowed. Only non-weight bearing ambulation was allowed in both groups till the fractire has healed rodiologically. The results were assessed using a 15-question patient-surgeon visual analogue scale. By the end of the follow up period, which exceeded 24 months in both groups, the overall results were significantly more satisfactory in group I [86%] than in group II [40%]. The rate of complications with the operative group was also low. The conclusion is; CT scans have improved the managementt of intraarticular calcaneal frractures. The results of conservative treatment can not be accepted in the modern era of orthopaedic practice. On the other hand, the results of open reduction and internal fixation are accepted, being more or less satisfactory by the patient, and reproducible