The Journal of Bone and Joint Surgery, Vol 76, Issue 10 1531-1540, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
Displaced intra-articular fractures of the calcaneus treated non-operatively. Clinical results and analysis of motion and ground-reaction and temporal forces
HB Kitaoka, EJ Schaap, EY Chao and KN An
Department of Orthopedics, Mayo Clinic, Rochester 55905.
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.
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