Results of thalamic calcaneal fracture treatment

Abstract

The aim: Analyzing the results of thalamic calcaneus fracture treatment in dependence of type and treatment method. Materials and methods: There were analyzed 198 clinical cases of calcaneal fractures treated in the clinic “V. Bețișor” during the years 2014-2016. Patients were divided into 2 groups - I (65 patients - 33%) treated surgically (open reduction and plate and / or screws osteosynthesis, capsulo-ligamentotaxisin the Ilizarov apparatus), II (133 patients-67%) treated conservatively. Men accounted for 81% (160) and women 19% (38). The average age was 45 years, with limits between 20 and 78 years. According to the values Böhler angle fractures were of grade II (101 cases) - 51%, grade I (60) - 30% and grade III (37) - 19%. Average length of stay was 13 days for patients treated surgically, and 7 days in patients treated conservatively. Results: Of the 198 patients were reexamined clinical and radiological and evaluated according to AOFAS Ankle-Hindfoot score Scale at 1-2 years from trauma 22 patients, of which 7 were performed surgical treatment, and 15 were treated conservatively. The results after surgical treatment (7): excellent (90 -100 p) -1 patient, good (72-89 p) - 4 patients, acceptable (41 – 71p) - 2 patients, bad (1-40 p) – 0, after orthopedic treatment (15): excellent -1 patient, good -6 patients, 6 patients acceptable, bad - 2 patients. Conclusions: 1. For the specifying the optimal treatment strategy is necessary a classification that could clearly definite the type of fracture. 2. Intra-articular fractures (thalamic) frequently require surgical tactics of treatment, reducing the articular surfaces ideal and stable fixation of the fragments. 3. The dominant principle in the treatment of these fractures is to restore the altered biomechanics of the foot.