OPERATIVE TREATMENT OF RECENT FRACTURES OF THE CALCANEUS

Abstract

The calcaneus is the largest tarsal bone; it plays an important role in carrying the body weight and in human locomotion. Numerous controversies have surrounded the management of patients who have a calcaneal fracture, the primary source of disagreement has been the issue of whether better results are achieved with operative or non-operative treatment. Open reduction and internal fixation has been used most commonly and in this work, thirty-two cases of calcaneal fractures were treated by open reduction and internal fixation in different hospitals including Ministry of Health, Military, Health Insurance, and some private hospitals. This study was held during the period of May 1996 till January 1999.

The subtalar joint should be treated as other weight-bearing joints with displaced intra-articular fractures by open reduction and rigid internal fixation. Good results of osteosynthesis depend on critical assessment of the indication for surgery and the soft tissues, precise knowledge of the anatomy of the calcaneus and its relation, as well as careful operation by an experienced surgeon. In this study, we considered that all patients with displaced fractures involving the articular surface of the subtalar joint with incongruent posterior facet, decreased or lost Bohler angle and displacement of the tuberosity or joint fragments are good candidates for operation unless a contra-indication was present.