Surgical management of intra-atricular fractures of the calcaneum

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Objective: To study the results of internal fixation of intra-articular fractures of calcaneum, specifically Type II and TypeIII fractures, as classified by Sanders et al. Methods: Thirty patients with displaced intra-articular fractures of calcaneum were treated with open reduction and internal fixation from September 2004 to July 2008. We used CT classification as proposed by Sanders et al to classify these fractures. Surgery was performed using the standard extended lateral approach. Fractures were reduced and fixed with y-plate and screws without bone grafting. All patients were started on early motion and maintained on non weight bearing for 10 months. Average follow up was 18 months (8 to 30months). The Creighton – Nebraska Heath Foundation Assessment Scale for fractures of the calcaneum was used to evaluate the results. Results: There were 12 excellent, 12 good, 6 fair results. All TypeII fractures had excellent results. The average value of restoration of Bholer’s angle was 5.2 degree. No significant complications noted. Conclusion: We recommend TypeII and TypeIII fractures of calcaneum to be treated with open reduction and internal fixation. Minimal complications were associated with this procedure.