Clinical efficacy of allogeneic bone grafting combined with open reduction and internal fixation in treating intra-articular calcaneal fracture

CHEN Tai-bang; SHI Ji-hong; XU Yong-qing; TANG Xun; LI Jun

doi:10.3969/j.issn.1009-4237.2016.02.006

Abstract：Objective To evaluate the clinical effect of open reduction and internal fixation of intra -articu-lar calcaneal fracture fixed with allogeneic bone grafting by imaging and function reecovery .Methods Two hun-dred and twenty-nine patients with displaced intra-articular calcaneal fractures that were treated with plate osteosyn-thesis from 2005 to 2013 were reviewed.One hundred and twenty-one patients (group A) were treated by plate os-teosynthesis with allogeneic bone grafting ,and 108 patients ( group B) were treated by plate osteosynthesis without bone grafting.Patients were followed up clinically and radiologically at least for 2 years.Radiological assessment was done by Bohler's angle and Gissane's angle along with measurement of calcaneal height and width .Functional outcome was assessed using the American Orthopaedics Foot and Ankle Society ( AOFAS) scale.Results The mean full weight-bearing time in group A (with bone grafting) was significantly less (median 3.5months) than that in group B (without bone grafting; median 5.3 months,P<0.05).Increase of Bohler's angle was more in group A than in group B(P<0.05).The average change in Gissane's angle and the average change in calcaneal height were not statistically significant for either group .The mean AOFAS score was higher in group A than in group B,but this difference was not significant (P>0.05).The occurrence rate of traumatic arthritis in group B was high-er than in group A(P<0.05).Conclusion Bohler's angle shows improved restoration and the patients return to full weight-bearing earlier when bone grafting is used in the treatment of intra-articular calcaneal fracture .However , bone grafting has a higher incidence of complications and the functional outcomes of the two groups are similar .