Radiological and functional comparison of conservative and percutaneous methods in calcaneus fractures with severe soft tissue injury and edema

There are different methods to treat calcaneus fractures. Since it is a weak area especially in terms of soft tissue coverage, an appropriate treatment method should be selected for the patient. Our goal in this study is to compare closed reduction-plastering (CRP) and closed reduction-percutaneous fixation (CRPF) techniques radiologically and functionally in patients unable to have open reduction-internal fixation due to severe soft tissue injury and edema. A total of 116 patients who underwent CRP (65 patients) and CRPF (51 patients) techniques between January 2015 and December 2018 at our clinic were included in the study. These two groups were divided into two subgroups according to the Sanders classification. Patients were evaluated according to follow-up time and fracture type. They were also evaluated radiographically based on fracture healing time and Böhler and Gissane angle measurements before and after treatment, and functionally using the AOFAS, MFS, and NPRS scales. Both groups had a mean follow-up of 3 years. In the CRPF group, the Böhler and Gissane angles were found to be restored better than in the CRP group, although this was not statistically significant (p=0.421, p=0.554, p=0.751, p=0.698). In functional evaluations with the AOFAS and MFS scales, better scores were calculated in the CRPF group and a statistically significant difference was found (p=0.017, p=0.023). Also, better outcomes were found for Sanders type 2 fractures than type 3 fractures. In patients with severe soft tissue injury and edema, a better reduction of functional outcomes can be achieved with the CRPF technique compared to CRP. This technique is convenient, reliable, and cost-effective. With this technique, more improvement can be achieved in radiological measurements. Finally, the Sanders classification has prognostic significance.

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