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BODYCAST - THE OFFICIAL JOURNAL OF THE CSOT Calcaneal fractures: The benefit of operative treatment By Alastair Younger, MD, MB ChB, FRCSC, Head, BC Foot and Ankle Clinic, Providence Health Care, and Clinical Associate Professor, Division of Lower Limb Reconstruction and Oncology, Department of Orthopaedics, University of British Columbia, Vancouver, BC Reprinted with permission from COA Bulletin ACO, August/September, 2003. In any other joint, bone or part of the body, a displaced intraparticular
fracture with malalignment is considered a surgical problem. It
would seem logical that restoration Upon starting practice, I had a chance to see these late results of nonsurgical treatment and found an anatomic reason for ongoing pain (except for the occasional patient with a regional pain syndrome): arthritic changes in the subtalar and calcano cuboid joints, impingement of tendons, anterior impingement of the ankle from the loss of heel height, and pain from calluses from abnormal loading of the foot were common complaints. The late reconstruction is a tough operation with high complication (non-union, malunion) and a long recovery time. This, combined with the prolonged disability between the injury and surgery, almost invariably lead to a reduction in job status. Successful early anatomic open reduction internal fixation avoids these complications.
This abstract is a portion of the article
which appears in the Fall 2004 issue of BodyCast.
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of
heel height, prevention of nerve and tendon entrapment, restoration
of normal anatomy of the heel cord, restoration of the normal contour
of the foot and contact characteristics, and preservation of the
joints by anatomic reduction would result in a better outcome for
these fractures.