Assessment of early outcomes of surgical treatment of comminuted fracture calcaneus through trans calcaneal approach

Abstract

Background: Treatment options for displaced intra-articular calcaneal fractures are still up for debate. The gold standard treatment for intra-articular calcaneal fractures is the conventional extensile lateral approach (ELA). Objective: achievement of good reduction with stable support for intra-articular calcaneal fractures by using trans calcaneal approach aiming for better functional outcome. Methods :On the basis of a prospective cohort research, at Zagazig University Hospital Orthopedic Department we recruited 18 patients with comminuted fractures in the calcaneus who had been admitted to the hospital with intra-articular fractures, Extensive lateral approach and T-plate fixation were used to treat this condition 3 and 6 months after surgery, the American Orthopedic Foot And Ankle Society's functional assessment was performed. Results: All patients eventually achieved full union by the end of follow-up. Only one patient had delayed union. Most of patients (55.56%) had good outcome according to AOFAS score. 11.11% had excellent outcome. While about one third of patients had unsatisfactory outcome, either fair (27.77%) or poor (5.56) AOFAS score. In regard to complications, most of the studied group (61.11%) didn’t have any complications, three patients had surgical site infection, and 11.11% of patients had sural neuritis. Conclusion: The trans-calcaneal method of reduction through ELA is an excellent method for treatment of displaced intra-articular calcaneal fractures, as it provides good exposure and facilitates anatomical reduction of fracture.