The long term results of internal fixation of displaced intra-articular calcaneal fractures.

One hundred and fourteen displaced intra-articular fractures of the calcaneus (47 tongue type and 67 joint depression type) were treated by open reduction and internal fixation with multiple H plate and were followed-up for an average of 6.75 years. All the fractures healed radiographically in 3 months. Average time for bone healing was 2.25 months for the tongue type and 2.42 months for the joint depression type (p > 0.05). Average post operative Bohler tuber angle was 25.05 and 22.71 degrees in the tongue type and joint depression type respectively (p > 0.05). All patients could return to work in 8 months. The average time for returning to work was 3.42 months in the tongue type and 4.16 months in the joint depression type (p < 0.05). Three calcanei (2.6%) had wound infection. There were significant differences between the two types in degree of residual pain, walking activities and range of subtalar joint movement. There were no significant differences in the ability to work, change of footwear and hind foot swelling. The end functional result was rated as excellent in sixty one (53.5%), good in twenty (17.5%), fair in fourteen (12.3%) and poor in nineteen (16.7%) calcanei. There was significant difference in the satisfactory result (excellent to fair) between the tongue type (91.5%) and joint depression type (77.6%).