OPERATIVE TREATMENT OF CALCANEAL FRACTURES IN ADULTS
Abstract
Background. Most researches prove that surgery is the only way to a successful treatment result of calcaneal fractures despite poor quality of existing data. However, complications are still frequent. Rehabilitation is rather lengthy and even if the surgery is successful, there is no guarantee for successful final treatment results.
Patients and methods. 48 patients with 52 calcaneal fractures operatively treated in General hospital Celje in the 3-year period were analysed. Plates and screws were used in 67% or wires in 27% of the cases involved. All the patients were reexamined on average 27 months after the injury. The results were evaluated according to the Maryland Foot Score (MFS).
Results. The average MFS result was 72 (SD 20). In 28 cases (58.3%) the results were excellent or good and in 13 cases (27.1%) the results were satisfactory. Only in 7 cases (14.6%) the results were unsatisfactory. The method of treatment, the fragment reduction and the wound healing complications did not show the statistical influence on the final treatment results. After the accidents only 30 of them (71.5%) were still working. They went back to work in approximately 6 months. 18 patients (42.9%) went back to the same position as they had before the accident.
Conclusions. Operative treatment of comminuted calcaneal fractures is accompanied by several complications. Constant use of the up-to-date diagnostic tools (CT) for evaluation of the injury and the treatment, appropriate surgical technique and the experience of the surgeon can reduce the number of the complications and their consequences. As high quality data show that operative treatment as a whole provides no improvement over nonoperative treatment in displaced intra-articular fractures, selection of the patient for surgery is crucial. Calcaneal fractures have a strong and important effect on a patient’s health as well as on his/her employment.
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