Need for Bone Grafts in the Surgical Treatment of Displaced Intra-Articular Calcaneal Fractures

• Published in: The Journal of foot and ankle surgery 2017-01, Vol.56 (1), p.54-58
• Main Authors: Duymus, Tahir Mutlu, MD, Mutlu, Serhat, MD, Mutlu, Harun, MD, Ozel, Omer, MD, Guler, Olcay, MD, Mahirogullari, Mahir, MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; allograft; Ankle Fractures - diagnostic imaging; Ankle Fractures - surgery; Bone Transplantation - methods; Böhler's angle; calcaneus; Calcaneus - diagnostic imaging; Calcaneus - injuries; Calcaneus - surgery; Case-Control Studies; Female; Follow-Up Studies; Fracture Fixation, Internal - methods; Fracture Healing - physiology; Humans; Intra-Articular Fractures - diagnostic imaging; Intra-Articular Fractures - surgery; Joint Dislocations - diagnostic imaging; Joint Dislocations - surgery; Joint Instability - prevention & control; Male; Middle Aged; Orthopedics; Radiography - methods; Retrospective Studies; Sander's classification; Statistics, Nonparametric; subtalar joint; trauma; Treatment Outcome; Young Adult
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2016.08.004

Abstract Controversy is ongoing regarding the use of bone grafts to fill cavities that occur with collapse of the posterior facet in the joint and for repair of the calcaneal height with plating. The present study included 40 patients with 43 displaced intra-articular calcaneal fractures treated with open reduction and internal fixation from March 2009 to November 2013. In the present case-control study, the patients were separated into 2 groups: group A received an allograft (20 patients, 22 calcaneal fractures) and group B did not (20 patients, 21 calcaneal fractures). The calcaneal height and Böhler's angle were compared between the 2 groups. The final outcomes for all patients were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot scale score and compared between the 2 groups. No significant differences were observed between the groups with regard to the basic demographic variables ( p  > .05). Using Sanders classification, 8 (18%) were type 2, 19 (44%) were type 3, and 16 (37%) were type 4 fractures. The comparisons between the 2 groups showed a loss of Böhler's angle and loss of calcaneal height that was significantly greater in group B ( p   .05). In conclusion, although no differences were found in the clinical results between the 2 groups, more satisfactory radiologic results were obtained in group A, in which bone grafts were used.