Evaluation of treatment of calcaneal fractures with a modified approach in a peripheral setting: A cost-effective model

摘要

Background: We present the results of open reduction and internal fixation of intra-articular calcaneal fractures with Kirschner wires with some modifications. Material and methods: A longitudinal study was done on 37 patients who had fallen from certain heights; the study subjects were predominantly construction workers. Forty-seven fractures of the study subjects were treated using a modified approach that includes incision and some tips in operative technique. Details of modification and their evaluation on the basis of restoration of heel shape with special attention to the lateral wall, radiological assessment of Bohler's angle, varus and valgus movement of the heel, pain while walking, patient satisfaction assessment upon return to pre-injury work are elaborated in this paper. Duration of study was from January 2000 to May 2011. Results: The fractures healed well with good radiological and functional outcomes, and patients returned to pre-injury work status in 4-6 months. Conclusion: The need to change to the Kocher approach for the treatment of calcaneal fracture with right-angled incision and elevation of the lateral flap is not necessary if the surgical tips showed in this paper are followed meticulously to achieve a good soft tissue outcome initially and, eventually, a good bony radiological and functional outcome. As implants used are very cheap and affordable to workers of low socioeconomic status, the authors have developed this method and presently believe that this method is best for all classes of patients with the said problem.