Operative Treatment of Displaced Intraarticular Calcaneal Fractures: Long-term (10-20 Years) Results in 108 Fractures Using a Prognostic CT Classification

摘要

Objective: The primary purpose of this study was to determine whether the Sanders computed tomography (CT) scan classification was still prognostic for outcome when long-term (10-20 years) radiographic and functional data of patients after open reduction and internal fixation for Sanders type II versus type m displaced intra-articular calcaneal fractures (DIACFs) were compared. The secondary purpose was to assess whether a bone graft or a locked plate was needed to maintain a reduction over time.Design: Prognostic case-control study. Setting: Level I trauma hospital.Patients: Patients with operatively treated Sanders type n/m DIACF managed between January 1, 1990, and December 31, 2000, by a single surgeon were identified from a prospectively gathered database. Skeletally mature patients with a closed isolated DIACF and a minimum of 10-year follow-up were included in this analysis. All fractures were classified according to Essex-Lopresti and Sanders. Of 638 fractures, 208 met the inclusion criteria.Intervention: Surgery consisted of a lateral extensile approach, posterior facet reduction, and lag screw fixation, followed by reduction of the anterior process and tuberosity with the application of a nonlocked lateral plate. Neither bone graft nor locking plates were used.