[Conservative treatment of calcaneus fracture versus repositioning and percutaneous bore wire fixation. A comparison of 2 methods].

From 1976 to 1985 we treated 236 patients with fractures of the calcaneum without additional injuries to the legs or pelvis. Among 129 patients, 22 female/107 male, with an average age of 50 and 42 years, respectively, we performed a total of 141 fractures of the calcaneum. The average post-traumatic follow-up was 6 years. For 62 fractures we performed conservative therapy with immobilization in plaster and for 79 fractures, reduction and percutaneous drill wire fixation. The fractures were classified according to Boehler, Watson Jones, and Essex Lopresti, and on the basis of the tuber joint angle (Boehler's angle). The resulting groups, however, were not homogeneously structured. Of 82 intraarticular fractures with fragment dislocation, 19 were treated conservatively and 63 surgically. Boehler's angle at trauma was 14 degrees in the conservative group and 2 degrees in the surgical group. The more severe types of fractures were thus treated by surgery. There were two Sudeck's dystrophies with conservative and three with surgical treatment. Inadequate surgical technique (drill wires extending greater than 2 mm over the bone and insufficient compression) led to the following complications: 10 drill wire perforations without subsequent complications, 8 drill wire migrations, 2 deep infections. In four patients drill wires had to be shortened, and in 1 patient drill wires had to be shortened, and in 1 patient drill wires were misplaced and had to be corrected. Surgically treated fractures were followed by arthrodesis in 2 patients, medialization of the lateral wall of the calcaneum in 1 patient, and peroneal tendon revision in 1 patient.(ABSTRACT TRUNCATED AT 250 WORDS)