The effect of fracture type and angular deterioration on the functional outcome of calcaneal fractures

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Objectives: The aim of this study was to determine the effect of fracture type and angular deterioration on the outcome of calcaneal fractures. Materials and methods: Thirty-two patients (23 males, 9 females; mean age 45 years) with calcaneus fractures retrospectively reviewed. Twenty-four fractures were closed, and eight fractures were open. Böhler and Gissane angles were measured using patient’s before, and after reduction X-ray films. According to the Essex-Lopresti classification there were three type I, 14 type II, and 15 type III fractures. Five patients were treated with casting (Group I), 19 patients with closed reduction K-wire application (Group II), and 8 patients with plate fixation. Final clinical outcome were assessed by Maryland Foot Score. Mean follow-up period was 109 weeks. Results: Mean Böhler and Gissane angles were 7°, 85° before reduction, and 20°, 100° after reduction, respectively. The mean Maryland Foot Score was 62 (range 55- 72) in Group I, 68 (range 40-90), and 66 (range 58-79) in group II. The Maryland Foot score in Type I fracture was higher than Type III (p=0.025), and Typ II (p=0.094), respectively. In terms of last radiologic examination, the Maryland Foot Score was higher in those angle’s were in normal border than whose angle’s were abnormal (p=0.027 and p=0.02, respectively). Mean correction of angles in Group III were more than Group I, and Gruop II (p 0.05). Conclusion: Severe calcaneus fracture was related to poor functional outcome. Böhler and Gissane angle can be more corrected with plate fixation method, but has similar functional outcome.

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Calcaneal fractures , surgery , casting , Böhler , Gissane angle

Dicle Medical Journal

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Dicle Medical Journal