IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 18, Issue 3 Ser. 8 (March. 2019), PP 01-05 www.iosrjournals.org DOI: 10.9790/0853-1803080105 www.iosrjournals.org 1 | Page Outcome of Calcaneal Fracture management by open reduction and fixation with bone grafting: A record based study Sanjay Barnwal 1 , Sanjay Gaikwad 1 *, Amogh Zawar 1 , Yogesh Rathod 1 , Aman Singh Chandel 1 Aniruddha A. Malgaonkar 2 1 Department of Orthopedics, Rajiv Gandhi Medical College, Kalwa, Thane, India 2 Department of Community Medicine, Rajiv Gandhi Medical College, Kalwa, Thane, India. Corresponding Author: Sanjay Gaikwad Abstract: This hospital based study was conducted to evaluate the functional and radiographic outcome after ORIF of displaced or depressed intra-articular calcaneal fractures treated only by K (Kirschner) wires with CC (Cannulated Cancellous) screw fixation and augmented with bone grafts. Outcome of patients as per American Orthopaedics Foot and Ankle Score (AOFAS) was observed post operatively and after 3 and 6 months. The difference in the AOFAS score of pre and post operative patients was statistically highly significant (p<0.00001). The difference between the participants in excellent category immediately post surgery and 6 months post surgery was statistically significant (X 2 =7.917, p=0.005). The lateral approach with K wire and CC screw fixation with bone graft is an effective option for management of displaced intra articular calcaneal fractures, resulting in good functional outcome. Keywords – Calcaneal Fracture, Open Reduction and Fixation, Bone Grafting --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 25-02-2019 Date of acceptance:11-03-2019 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Calcaneal fractures correspond to 2% skeletal fractures and about 60% of the fractures of tarsal bones. 1,2 A total of 70% calcaneal fractures are intra articular and 30% are extra articular. 3-5 The incidence of calcaneal fracture has remained relatively constant 5 even with the advent of mechanized industry, increasing number of road traffic accidents as it has been a common injury since man began to climb trees, to work from heights & farms. The most common modes of injury in fracture calcaneum are fall from height, brake pedal injuries and high velocity trauma. Talus is driven down into calcaneum by axial loading mode of injuries which results in primary fracture line. Essex lopresti described secondary fracture lines which can produce tongue type and joint depressed type calcaneal fractures. 5,6 Calcaneal fractures often result in early and late complications like a Varus deformity with heel widening, loss of calcaneal height, subtalar joint incongruency, peroneal tendon impingement, malunion ifv not treated properly, hence focus has been targeted on operative management as it provides the opportunity for anatomical reduction and rigid internal fixation of displaced intra articular fractures of the calcaneum by Open Reduction and Internal Fixation (ORIF). 7-9 There are various modalities of treatment for fracture calcaneum such as cast, percutaneous fixation, external fixator, and ORIF with plating and each modality has its own pros and cons. Despite the great development of orthopaedic traumatology, modern surgical techniques, 3D computed tomography scans and other hardware, the best treatment option for these fractures is controversial. Conservative treatment of intra articular fractures is not that successful due to incongruency of articular surface, widening of heel, talar dorsiflexion, loss of calcaneal height and peroneal tendon impingement. Hence the focus has been based on operative management as it provides the opportunity for anatomic reduction thereby restoring the biomechanics and function of the hind foot, heel width and length and alignment of the Achilles tendon. The extensile lateral approach with lateral surface calcaneal plating is widely used for the surgical fixation of the intra articular calcaneal fractures because of its excellent exposure and good results. But it also has soft tissue complications such as wound edge necrosis, wound dehiscence, infection which is majorly seen in patients with co morbid conditions like smoker and diabetics. 10,11 Because of this reason there have been many new advances of various approaches for ORIF of calcaneal fractures. We evaluate the outcomes of ORIF of displaced intra articular fractures of calcaneum with minimal implantation through the lateral approach.