الفهرس 
Introduction and Aim of The Work
Material and MethodsOnly 14 pages are availabe for public view
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Abstract
The aim of this work is to study the outcome of surgical treatment of displaced intraarticular fracture of the calcaneum. Forty five patients with fifty intraarticular calcaneal fractures were treated by ORIF through the period from March 2003 to June 2005. Males were more affected than females with the ratio of 4.6:1. The age of the patients ranged from 18 to 55 years with mean age 33 years. Falling from hight was the most common cause of injury. Cases were classified according to Paley classification, 2 cases were two part fracture (4%), 17 cases were tongue type fracture (34%), 28 cases were central depression (56%), and 3 cases were comminuted (6%). Cases were operated between the 5 th day and the 14 th day after injury with most of the cases were operated on the 6 th day. All of the cases were placed on the lateral decubitus position, and operated through extensile lateral approach. Bone graft was used in all cases. Out of the fifty cases included in this study, 35 cases (70%) were graded as excellent, 7 cases (14%) were graded as good, 6 cases (12%) were graded as fair and 2 cases (4%) were graded as poor. We conclude that fractures of the calcaneum should be treated like other intraarticular fractures, i.e., anatomical reduction, stable fixation and early mobilization. These goals are achievable and give very good to excellent results. In severely comminuted fractures open reduction is attempted first to restore the overall shape of the calcaneum and also the subtalar joint, if possible. However, at the same time, we must prepare for primary fusion if we find the subtalar joint is beyond our ability to reconstruct. In either way, the overall shape of the calcaneum is restored. Thus, even if subtalar arthritis occurs in the later stage, it would be easier to perform the reconstructive surgery and the end result would be more acceptable. The best time to do ORIF in calcaneal fractures is between the 5 th day and the 10 th day after injury. Extensile lateral approach when done properly gives good exposure and is associated with decreased incidence of soft tissue complication. Adequate restoration of the Bohler angle and Crusial angle of Gissane is mandatory to achieve good results. Early rehabilitation is essential to preserve the motion around the ankle joint and the subtalar joint.