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Médecine et chirurgie du pied

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Fractures of the Calcaneus: Complications and Results of Plate Osteosynthesis. About a Series of 26 Cases Volume 36, issue 2, Juin 2020

Tables


  • Tableau 1

  • Tableau 2
Authors

Introduction

The fractures of the calcaneus are frequent involving a young male patient after having a high energy trauma. The functional complications are valgus flat foot and subtalar osteoarthritis. Different treatments are possible. The osteosynthesis by locked plate can rebuild the anatomy of the calcaneus hoping a good result. The main objective of this work was to study the skin and septic complications after osteosynthesis of the calcaneus fractures by plates. The second objective was to evaluate the functional results and the onset of subtalar osteoarthritis. Our hypothesis was that the complication rate was low.

Material and methods

It is a monocentric retrospective study including the osteosynthesis of the calcaneus using a locked plate (February 2008 to March 2015) with the exception of the patients with severe morbidity.

Results

We have included 26 osteosynthesis in 23 patients. Most of them were young males (82.6%, mean age: 39 years old). The mean follow-up is 32 months. 23 fractures have been analyzed. We have found 5 skin or septic complications where 3 needed a reoperation. They were correlated to tobacco addiction. The mean AOFAS score was 74.2 (33–95). The functional results were excellent in 22% and good in 44% of the cases. The working accidents, the tobacco addictions, the grade V fractures according to Duparc classification were of bad prognosis. We have found 10 cases of subtalar osteoarthritis. 6 grades 4 were correlated with bad functional scores. 5 patients have undergone a subtalar arthrodesis.

Discussion

We have found a slightly lower rate of complications when compared to the literature, correlated to tobacco addiction. The functional scores were slightly higher and the dysesthesia of the sural nerve were quite frequent. The subtalar osteoarthritis happens in one in two cases. The rate of the complications and the functional results lead to reconsider the surgical technique and its indication. Minimal invasive surgery and percutaneous approach could be an interesting way.

Conclusion

The fractures of the calcaneus need a surgery “à la carte”, according to the associated lesions, especially concerning the skin and the general status of the patient. Indeed the complications due to open surgery can be deleterious.