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Year : 2020  |  Volume : 3  |  Issue : 3  |  Page : 121-126

Reduction and functional outcome of open reduction and internal fixation with plate versus minimally invasive screw fixation in displaced intra-articular calcaneum fractures

Department of Orthopaedic Surgery, Liaquat National Hospital and Medical College, Karachi, Pakistan

Correspondence Address:
Farhan Sozera
Department of Orthopaedics surgery, Block K, 1st Floor, Liaquat National Hospital and Medical College, National Stadium Road, Karachi 74800
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JODP.JODP_18_20

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Introduction: Calcaneum fracture accounts for 2% of all fractures and 60% of all tarsal bone fractures. The most favored treatment for intra-articular fractures is open reduction and internal fixation using an extended lateral approach. The use of minimally invasive reduction and fixation of calcaneal fractures may have a role in this group of patients where there is a concern regarding wound healing and infection. Materials and Methods: This was a prospective study conducted from April 1, 2016, to April 30, 2018. Eighteen patients were included in the study. Preoperative and postoperative plain radiographs were compared for reduction parameters (improvement of Bohler's angle or Gissane's angle, the width of the calcaneus), Functional outcome was assessed using American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot score and visual analog scale. Results: The patients followed up for an average of 15.56 ± 4.85 months. No significant differences in reduction were observed between the open and closed groups (P > 0.05). The average AOFAS scores of the two groups were 76.45 ± 6.83 and 84.65 ± 7.65 (open versus closed) (P = 0.087). The mean visual analog scores of the open and closed groups were 1.38 ± 1.15 and 0.75 ± 0.45 (P = 0.034). The complication rates of the open and closed groups were 33% (3/9) and 10% (1/9) (P = 0.0053). Conclusion: Closed reduction and percutaneous screw fixation have shown better results in terms of outcome and complications. However, multicenter controlled randomized clinical trials are still required prior to widespread practical implementation.

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