OUTCOMES OF CONSERVATIVE AND SURGICAL TREATMENT OF CALCANEUM FRACTURES IN A LARGE CASE SERIES

Abstract

Objectives: To report the outcome and comparison of calcaneum fracture managements for intra-articular fractures.

Methods: A prospective study of the patients with intra-articular calcaneum fractures in the foot& ankle unit of a busy trauma hospital. All the patients were followed up with the calcaneal fracture score.

We compared the outcome of surgical management Sanders type 2 (Group A) and type 3 (group B) fractures with conservative treatment (group C) at 2 years and assessed the medium term outcomes of groups A and B. Group C were a consecutive series of patients recruited to the study later than A and B, hence the smaller number in that group.

Results: 126 patients were included in our study. There were 70 in group A, 38 in group B, and 18 in group C. Mean follow-ups for the groups were A=6y, B=5.5y and C=2.34y. Mean two-year scores for the groups were A=68.13, B=63.78, and C=51.36, with statistically significant differences between groups A and C (P=0.0006), and between groups B and C (P=0.04), but no significant difference between groups A and B.

At medium-term follow-up (> 5 years), the scores for group A and B were 77.06 and 63.66 respectively.

There were 7 deep, 5 superficial infections and 32 metalwork removals in total.

Conclusion: On comparing the medium term outcome to the two-year one, group A showed some improvement and group B stayed the same.

In this series, there was a better outcome at two years with surgical treatment than conservative treatment.