Functional and Radiological Outcomes of Plate Osteosynthesis in Closed Displaced Intraarticular Calcaneal Fractures

Abstract

INTRODUCTION: Calcaneum fractures, particularly closed, displaced intraarticular fractures, are uncommon yet cause significant morbidity and impair quality of life (QOL). While open reduction and internal fixation a standard treatment, debate on optimal management continues. This study evaluated functional outcomes of plate osteosynthesis for these fractures, focusing on QOL and radiological measures. MATERIALS AND METHODS: This retrospective study reviewed records of patients with closed displaced intraarticular calcaneal fractures treated with plate osteosynthesis (January 2015-December 2020) at a single tertiary centre. Surgery involved open reduction and internal fixation using a locking calcaneal plate, performed on average 11 days post-trauma. Follow-up assessments were conducted for a minimum of one year, utilising the SF-36 for QOL and measuring Böhler’s angle. RESULTS: Twenty-six patients (25 males, 1 female; mean age 42.8 years) were included. Fractures were primarily caused by motor vehicle accidents (65.4%). The mean QOL score was 55.9, and the mean post-operative Böhler’s angle was 22°. Fracture type (Sanders’ classification) was significantly associated with Böhler’s angle. Correlation analysis revealed a weak, non-significant positive correlation between Böhler’s angle and SF-36 scores (r = 0.187, r² = 0.035, p = 0.360). Superficial infections occurred in 7.6% of cases, all resolving without further surgery. CONCLUSION: Plate osteosynthesis for closed, displaced intraarticular calcaneum fractures provides favourable functional outcomes and restores anatomical alignment. The weak correlation between radiological restoration and patient-reported function suggests that additional factors may influence overall recovery.