Treatment of intra-articular calcaneal fractures: evaluation of results

Abstract

Objective: To assess the results of calcaneous intra-articulate fractures treated conservatively or surgically between 1996 and 2007. Methods: Forty-two patients with 46 calcaneous intra-articulate fractures were studied. After physical exam, radiographs and computerized tomography, the fractures were divided into three treatment groups: Group I, conservative: use of a cast boot for six weeks, indicated for articular fractures without displacement and in those with displacement, but with surgical contraindications; Group II, technique of Essex-Lopresti: fractures in tongue and central depression in block; Group III: fractures treated surgically with plates and/or screws, tomographically classified as Sanders II and III. The results were assessed using the evaluation scale of the American Orthopaedic Foot and Ankle Society (AOFAS). Results: The mean follow-up was 27 months (6 to 132 months). Group I presented as result an average of 71,1 points, Group IIpresented 77,1 and Group III 69,4 points. Conclusions: In Group I, the intra-articular fractures with displacement, with no conditions for surgery and treated conservatively, showed significantly worse results than those without displacement. In Group III, the fractures treated through open reduction and internal fixation which presented surgical complications had significantly worse results than those which developed without complications. In spite of different samples of fractures, there was no statistical difference between the results obtained in the different treatment groups employed. The best results happened in the group of fractures treated through the Essex-Lopresti method.