SLR - November 2009 - Shanta L. Griffin
Reference:
Potter, M.Q., Nunley, J.A. (2009). Long-term Functional Outcomes after Operative Treatment for Intra-articular Fractures of the Calcaneus. The Journal of Bone and Joint Surgery (American), 91, 1854-1860.
Scientific Literature Review
Reviewed by: Shanta L. Griffin
Residency Program: Central Alabama Veterans Health Care System
Podiatric Relevance:
This study provides long-term outcomes for the surgical management of intra-articular calcaneal fractures.
Methods:
This was a retrospective study examining81 intra-articular calcaneal fractures in 73 patients. Patients who suffered calcaneal fractures from1989-2003 were identified via a medical record review. Patients were excluded if they either did not have an intra-articular fracture or because plate and screw fixation was not used during their surgical intervention. Postoperative functional outcome scores were assessed using the Calcaneal Fracture Scoring System, the Foot Function Index, and the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale (subjective portion only).
Results:
Median duration of follow up was approximately 13 years. The mean scores for the three scoring systems were as follows: AOFAS Ankle-hindfoot score was 65.4, Foot Function Index score was 20.5, and Calcaneal Fracture Scoring System was 69.3; all with max scores of 100. Thirteen (18%) patients reported additional surgery since their initial repair, which included 7 who had removal of painful hardware, 3 who had irrigation and debridement of an infected wound, 2 (3%) who had a subtalar joint fusion, and 1 with tarsal tunnel release. There was evidence of statistical significance regarding patients with fractures sustained in motor vehicle accidents being worse than those with fractures caused by a fall.
Conclusions:
Calcaneal fractures can be debilitating. This study provides valuable guidance relating to the long term operative management of intra-articular calcaneal fractures. This study is limited for comparison due to the lack of control patients managed non-operatively.