The Journal of Bone and Joint Surgery, Vol 75, Issue 3 331-341, Copyright © 1993 by Journal of Bone and Joint Surgery, Inc
Late complications of fractures of the calcaneus
M Myerson and GE Quill
Foot and Ankle Center, Union Memorial Hospital, Baltimore, Maryland 21218.
We retrospectively reviewed the results of the operative treatment of
forty-three fractures of the calcaneus in forty-two patients (thirty-six
men and six women). The operations had been performed a mean of twenty-six
months (range, six to seventy-two months) after the injury. An in situ
subtalar arthrodesis had been performed in fifteen patients; a subtalar
distraction bone-block arthrodesis, in fourteen; a triple arthrodesis, in
five; a lateral calcaneal ostectomy, in seven; a transection and proximal
transposition of the sural nerve, in seven; and a release of the tibial
nerve, in five. The patients were examined at a mean of thirty-two months
(range, twenty-six to fifty-two months) after the operation. The difference
between the preoperative and postoperative rating scores was used to
measure any improvement in function. Pain was partially relieved in
thirty-eight (90 per cent) of the patients, function improved in
thirty-five (83 per cent), and thirty-two (76 per cent) of the patients
returned to work or to a pre-injury level of activity at a mean of eight
months (range, four to sixteen months) after the operation. There was a
trend (p = 0.07) that the longer the interval between the injury and the
operation, the longer the subsequent interval until the patient returned to
full activities or work. The most successful results were in the patients
who had had a subtalar arthrodesis.
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