• Qing-Peng Sun.
• Xiangyang Hospital of Traditional Chinese Medicine Affiliated to Hubei University of Traditional Chinese Medicine, Xiangyang 441000, Hubei, Chinese.
• Zhongguo Gu Shang. 2013 Nov 1;26(11):897-900.

ObjectiveTo observe the outcome of treatment for serious old intra-articular calcaneal fracture by reconstruction of calcaneal thalamus and subtalar arthrodesis and to summarize the operative indications and its attention points.MethodsFrom March 2006 to July 2011,26 patients with Sanders type III old intra-articular calcaneal fracture were treated including 15 males and 11 females with an average age of 34 years old ranging from 27 to 45 years old. The clinical courses ranged from 7 to 24 months with an average of 18 months. Before the operation,X-ray and CT showed that Gissane angle increased while Böhler angle decreased,and calcaneus broadened,bulging on both sides. After the operations,all patients tested by imaging examination, and the width of calcaneus, the height of calcaneal thalamus, the Böhler angle and Gissane angle were measured to compare with the preoperative data. Besides, for identification of improvement of the operation,the functions of patient's feet after the operation were graded according to AOFAS Ankle-Hindfoot Scale to compare with preoperative data.ResultsAmong them, 24 patients were followed-up from 5 to 26 months with an average of 19 months. X-rays confirmed that all cases healed successfully. There were no serious infection, and only one skin necrosis case. Sural neurocutaneous island flap was used to repair the skin with success. According to AOFAS Ankle-Hindfoot Scale, the total score increased from preoperative (41.00 +/- 8.22) to postoperative (79.04 +/- 7.46). There were 3 cases of excellent result, 15 cases of good result,and 6 cases of fair result. Postoperative width of calcaneus, the height of thalamus, Böhler angle and Gissane angle were better than that of preoperative data, and had statistical significance between two groups.ConclusionSubtalar arthrodesis with the reconstruction of calcaneal thalamus is an effective way to treat old intra-articular calcaneal fractures. It can correct the calcaneal deformity, restore the shape of foot and improve the function of hind foot.

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