Management of calcaneum fracture in adults treated with plating

Intraarticular fractures of Calcaneum are not uncommon. Among the tarsal bones calcaneus is most frequently fractured. Calcaneal fractures account for 60% of tarsal bone injuries and 2% of all fractures. Axial loading is most common mode of injury, fall from height causing bilateral calcaneal fractures. Other fractures associated with fall from height have to be excluded such as pelvic and spinal fractures.

This is a prospective study of 20 patients with displaced intraarticular fractures (Type-II Sanders and above) of calcaneum, which were admitted to the hospital and operated with plating and bonegrafting through extensile lateral approach, between September 2013 and February 2016.

A total of 20 calcaneal fractures in 24 patients were randomly selected treated by plating for example locking calcaneal plate. Among the 20, there was predominance of right sided fractures.

Open reduction and internal fixation of displaced intra-articular calcaneal fractures by locking calcaneal plate maintains the joint congruity and decrease the incidence of subtalar arthritis. Although, conservative treatment was considered gold standard previously, there is increase tendency towards internal fixation with excellent results. Surgery for calcaneus fractures should be delayed, ideally for 10–14 days, in the presence of significant edema or fracture blister formation.

Based on our small study and results, we conclude that open reduction and internal fixation with locking calcaneal plate is excellent treatment option with good post operative outcome for displaced fracture of calcaneum, as serious complications are not significant.