Original research| Volume 43, ISSUE 6, P374-379, November 2004

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Functional evaluation of intraarticular severely comminuted fractures of the calcaneus with gait analysis

      Twenty-one patients (23 feet) treated nonsurgically for severely comminuted intraarticular fractures of the calcaneus were evaluated prospectively with a clinical scoring scale and computerized gait analysis. All patients had Sanders type III and type IV fractures. The treatment protocol consisted of no closed reduction, immobilization in removable splint, physiotherapy after edema subsided, and weightbearing after 8 weeks. All patients had a minimum follow-up of 2 years (mean, 38 months). Clinical results were good in 2 patients, fair in 3 patients, and poor in 16 patients. Gait analysis showed that patients were at high risk of gastrocnemius weakness and ankle and knee instability. These results may be useful for comparison with the results of other methods, such as open reduction and internal fixation, nonsurgical closed reduction, and arthrodesis.

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        • Barei D.P.
        • Ballabarba C.
        • Sangeorzan B.J.
        • Benirschke S.K.
        Fractures of the calcaneus.
        Orth Clin North Am. 2002; 33: 263-285
        • Bézes H.
        • Massart P.
        • Delvaux D.
        • Fourquet J.P.
        • Tazi F.
        The operative treatment of intra-articular calcaneal fractures.
        Clin Orthop. 1993; 290: 55-59
        • Crosby L.A.
        • Fitzgibbons T.
        Intra-articular calcaneal fractures.
        Clin Orthop. 1993; 290: 47-54
        • Eastwood D.M.
        • Phipp L.
        Intra-articular fractures of the calcaneum.
        Injury. 1997; 28: 247-259
        • Lim E.V.A.
        • Leung J.P.F.
        Complications of intra-articular calcaneal fractures.
        Clin Orthop. 2001; 391: 7-16
        • Sanders R.
        Current concepts review—displaced intra-articular fractures of the calcaneus.
        J Bone Joint Surg. 2000; 82A: 225-250
        • Huang P.J.
        • Fu Y.C.
        • Cheng Y.M.
        • Lin S.Y.
        Subtalar arthrodesis for late sequela of calcaneal fractures.
        Foot Ankle Int. 1999; 20: 166-170
        • Tornetta P.
        Percutaneous treatment of calcaneal fractures.
        Clin Orthop. 2000; 375: 91-96
        • Hutchinson F.
        • Huebner M.K.
        Treatment of os calcis fractures by open reduction and internal fixation.
        Foot Ankle Int. 1994; 15: 225-232
        • Stephenson J.R.
        Treatment of displaced antra-articular fractures of the calcaneus using medial and lateral approaches, internal fixation, and early motion.
        J Bone Joint Surg. 1987; 69A: 115-130
        • Zwipp H.
        • Tscherne H.
        • Thermann H.
        • Weber T.
        Osteosynthesis of displaced intra-articular fractures of the calcaneus.
        Clin Orthop. 1993; 290: 76-86
        • Chandler J.T.
        • Bonar S.K.
        • Anderson R.B.
        • Davis H.
        Results of in situ subtalar arthrodesis for late sequelae of calcaneus fractures.
        Foot Ankle Int. 1999; 20: 18-24
        • Kitaoka H.B.
        • Schaap E.J.
        • Chao E.Y.S.
        • An K.N.
        Displaced intra-articular fractures of the calcaneus treated non-operatively.
        J Bone Joint Surg. 1994; 76A: 1531-1541
        • Marti R.K.
        • de Heus A.C.
        • Roolker W.
        • Poolman R.W.
        • Besselaar P.P.
        Subtalar arthrodesis with correction of deformity after fractures of the os calcis.
        J Bone Joint Surg. 1999; 81B: 611-616
        • Pozo J.L.
        • Kirwan E.O.
        • Jackson A.M.
        The long term results of conservative management of severely displaced fractures of the calcaneus.
        J Bone Joint Surg. 1984; 76B: 386-390
        • Salama R.
        • Benamara A.
        • Weissman S.L.
        Functional treatment of intra-articular fractures of the calcaneus.
        Clin Orthop. 1976; 115: 236-240
        • Catani F.
        • Benedetti M.G.
        • Simoncini L.
        • Leardini A.
        • Giannini S.
        Analysis of function after intra-articular fracture of the os calcis.
        Foot Ankle Int. 1999; 20: 417-421
        • Rosenbaum D.
        • Lübke B.
        • Bauer G.
        • Claes L.
        Long-term effects of hindfoot fractures evaluated by means of plantar pressure analyses.
        Clin Biomech. 1995; 10: 345-351
        • Shafiq M.S.
        • Tümer S.T.
        • Güler H.C.
        Marker detection and trajectory generation algorithms for a multicamera based gait analysis system.
        Mechatronics. 2001; 11: 409-437
        • Toth K.
        • Boda K.
        • Kellermann K.
        • Zadravecz G.
        • Koresmar J.
        Clinical and gait analysis of 171 unilateral calcaneal fractures.
        Clin Biomech. 1997; 12: S17-S18
        • Sanders R.
        • Fortin P.
        • DiPasquale T.
        • Walling A.
        Operative treatment in 120 displaced intra-articular calcaneal fractures.
        Clin Orthop. 1993; 290: 87-95
        • Güler H.C.
        Biomechanical Modeling of Lower Extremity and Simulation of Foot During Gait.
        Mechanical Engineering Department, Middle East Technical University, Ankara, Turkey1998 ([dissertation])
        • Randle J.A.
        • Kreder H.J.
        • Stephen D.
        • Williams J.
        • Jaglag S.
        • Hu R.
        Should calcaneal fractures be treated surgically? A metaanalysis.
        Clin Orthop. 2000; 377: 217-227
        • Tennent T.D.
        • Calder P.R.
        • Salisbury R.D.
        • Allen P.W.
        • Eastwood D.M.
        The operative management of displaced intra-articular fractures of the calcaneus.
        Injury. 2001; 32: 49-496

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