Operative treatment of displaced intra-articular fractures of the calcaneus using absorbable internal fixation: a prospective study of twenty-five fractures.

OBJECTIVE

To document the use of absorbable implants in the operative treatment of displaced intra-articular fractures of the calcaneus.

DESIGN

Prospective clinical study.

SETTING

Level one trauma center, university hospital.

PATIENTS: Twenty-five displaced intra-articular calcaneal fractures in twenty-one patients.

INTERVENTION: The fractures were reduced operatively and fixed with absorbable self-reinforced polyglycolide rods.

MAIN OUTCOME MEASUREMENTS: Reduction, healing, and stability of fixation were assessed on radiographs. The functional result was scored using the method of Crosby and Fitzgibbons. Patient satisfaction was recorded.

RESULTS

The mean Böhler angle was -12 degrees (standard deviation 22 degrees) preoperatively and 20 degrees (standard deviation 13 degrees) postoperatively. After a two-year follow-up, seven patients had excellent, five good, three fair, and six poor functional results. Subjectively, fifteen patients were satisfied and six were dissatisfied. Twelve patients returned to work within one year, three were unemployed, two were retired prior to the accident, and four were unable to work because of the calcaneal fracture. The postoperative Böhler angle and later the appearance or absence of posttraumatic subtalar arthritis were significant prognostic factors.

CONCLUSIONS

Results with absorbable implants are similar to those with other operative methods. Advantages include the absence of secondary procedures for implant removal and undisturbed computed tomography scans postoperatively.