Long-term results and physiotherapeutic determination in operative treatment of intra-articular calcaneal fractures

Abstract

The authors present their own observations of the surgical treatment of articular calcaneal fractures using a minimally invasive percutaneous fixation in combination with the unifi ed self-developed physiotherapy program. The analyzed techniques include the Westhues’ technique and its modifi cation with additional stabilization of the bone fragments with Kirschner wires, as well as transdermal stabilization by Rąpała. The research material comprises 82 patients with intraarticular fractures - 68 men (83%) and 14 women (17%) treated surgically between 1990 and 2012. The analyzed calcaneus fractures were divided by Essex–Lopresti scale and evaluation of functional outcome at follow-up was based on the Creighton–Nebraska criteria. Men with the “tongue type” fracture treated using the Westhues’ technique had good functional outcomes in 12 cases (17.6%) and acceptable in 7 cases (10.3%). Women with the “tongue type” fracture treated using the Westhues’ technique had good functional outcomes in 2 cases (14.3%) and in one case, poor (7.1%). After analysis of the material, the authors claim that minimally invasive techniques are not really minimally invasive, taking the observed complications into consideration in most of the patients, which lead to the poor functional outcome at long term follow-ups. Cite this article as: Golec P., Tomaszewski K.A., Nowak S., Dudkiewicz Z. Long-term results and physiotherapeutic determination in operative treatment of intra-articular calcaneal fractures. . Med Rehabil 2016; 20(1): 5-11.

Keywords

• intra-articular
• calcaneal fractures
• complications
• physiotherapy