Abstract
Purpose of the study: is to evaluate the wound healing problems following. Open reduction and internal fixation (ORIF) of calcaneal fractures. Introduction: Calcaneal fracture is challenging to all orthopaedic surgeons. It can be disabling injury with economical consequences, particularly it usually happen in men workers. ORIF is often needed to improve the final outcome of these difficult injuries. However, without careful selection of patients, time of surgery and using meticulous surgical technique, wound breakdown (the most frequent complication) can be disastrous. Material and Method: We reviewed 45 consecutive series calcaneal fractures treated by O.R.I.F. between 1996 and 2001.
The mean age was 36 years (range 18 to 57) All but one fracture resulted from a fall from height. Cases were analyzed to ascertain the mechanism of injury, associated injuries, presence of medical problems e.g. Diabetes or peripheral vascular disease, smoking. Number of days elapsed before surgery, method of wound closure, and the use of drain and Saunders grade. Results: All patients were Saunders grade two& three in our study. Fourteen were smokers. No one with peripheral vascular compromise, Body mass Index was within normal limit in all of them. Average time elapsed before surgery was 8 days. All operations were done by one surgeon, who closed all wounds in layers and regularly used a drain. We had four (11%) delayed healing (more than 2 weeks). No serious wound problems needing free flaps or amputation. Conclusion: ORIF for certain calcaneal fractures greatly improve the outcome of these unpleasant injuries. Appropriate patient selection and adherence to meticulous surgical technique significantly reduces wound healing problems.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
