Displaced intra-articular fractures of the calcaneus treated non-operatively. Clinical results and analysis of motion and ground-reaction and temporal forces

J Bone Joint Surg Am. 1994 Oct;76(10):1531-40. doi: 10.2106/00004623-199410000-00013.

Abstract

Twenty-seven patients who had a unilateral displaced intra-articular fracture of the calcaneus were managed with a cast instead of with reduction or an operation. The clinical result after a mean of six years (range, two to ten years) was excellent in five patients, good in five, fair in seven, and poor in ten. The sixteen patients who were re-examined for this study and for whom the gait was analyzed demonstrated abnormalities in ground-reaction force with regard to vertical force (F3) and temporal force factors (T2, T3, T6, and T9). Analysis of temporal and distance factors showed a trend toward a decreased proportion of single-limb support on the involved side. Three-dimensional motion analysis of the ankle and hindfoot was performed with electrogoniometers as the subject walked on a level surface, on a 10-degree side-slope, and up and down stairs. Motion was decreased in the sagittal, coronal, and transverse planes during walking on level ground and on a side-sloping surface. Significant decreases in motion in these planes were also seen during walking up and down stairs. Although these patients did not have a subsequent reconstructive operation, most had a residual functional deficit.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Ankle Joint / physiopathology
  • Calcaneus / diagnostic imaging
  • Calcaneus / injuries*
  • Casts, Surgical*
  • Female
  • Follow-Up Studies
  • Foot / physiopathology
  • Fracture Healing / physiology
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / physiopathology
  • Fractures, Bone / therapy*
  • Gait
  • Humans
  • Male
  • Middle Aged
  • Radiography
  • Range of Motion, Articular / physiology
  • Retrospective Studies
  • Walking / physiology