Management of the displaced intra articular fracture calcaneum by open reduction & internal fixation with the locking calcaneum plate: A study

Introduction: Since the mid-nineties, open reduction and internal fixation is considered as the gold standard treatment for the displaced intra-articular fractures of the calcaneus by most experts. However, there still remains dilemma regarding the adequate management strategy for these complex and unsolved fractures & hence, the intent of our study is to resolve many of the issues related to this fracture. Materials and Methods:25 patients of closed fracture calcaneum (Type 2, 3 & 4 Sanders classification) operated with the open reduction & internal fixation between the year 2011 and 2014 were included in the study. During follow-up, pain, functional outcome, range of motion etc. were evaluated with the use of the Maryland Foot Score (MFS). Results:We studied 25 patients who had a combined total of 30 closed displaced intra-articular calcaneal fractures of Type 2, 3 & 4 (Sanders classification) for a mean follow-up period of 13.4+/-1.35 months. Complications seen post-operatively were persistent swelling in 2 cases (6.6 %) & Skin complications in 2 cases (6.6 %). The pre and postoperative values of Bohler's angle, Gissane's angle, height and width show restoration of normal anatomy and this change in the values was significant as p-value was< 0>+/- 12.5 (Good). Conclusion: Overall quality of fracture reduction, as judged by restoration of Bohler's angle, Gissane's angle, height and width were good. So, open reduction and internal fixation should be the treatment of choice in such fractures. Level of incidence:Therapeutic Level IV.