Outcome of operatively treated os calcis fractures - the Southampton experience

N. Vasukutty, V. Kumar, M. Diab, W. Moussa

Introduction: This is a retrospective review of 80 intra articular calcaneal fractures treated by open reduction and internal fixation by a single surgeon in a tertiary centre between 2005 and 2014.

Methods: The fractures were evaluated with plain radiographs and CT scan and graded using Eastwood Atkins classification. A lateral approach was used and all fractures were fixed with calcaneal plates. All cases had clinical and radiological follow up. Clinical assessment included Foot and Ankle Disability Index and SF 36 scores.

Results: The mean follow up was 63 months (3-121). Average age of patients was 49 (17 - 73) There were 3 open fractures and 8 patients had other injuries. The mean Bohler's angle improved from 6 degrees preoperatively to 26 degrees post operatively. Mean Foot and Ankle Disability index scores were 78.62 and SF 36 scores were 45.5 (physical component) and 52.6 (mental component). Early complications included 1 case of screw in subtalar joint, 1 Sural Nerve injury and 1 wound breakdown, which healed with non operative measures. 12 patients had symptomatic subtalar joint osteoarthritis out of which 4 had subtalar fusion.

Conclusions: These results compare favourably with peer-reviewed literature. We recommend prompt osteosynthesis in intra articular calcaneal fractures to restore hind foot shape and Bohler's angle.