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[Long-term results comparison of simultaneous open reduction and subtalar arthrodesis with the efficacy of closed reduction in the treatment of fresh fractures of calcaneus].

AIM
The aim of the study was the retrospective comparison of results of treatment of fresh fractures of calcaneus with open reduction and simultaneous subtalar arthrodesis performed at Orthopaedic and Traumatology Department in Lublin with closed reduction according to Westhues in Traumatology and Orthopaedic Department in Krosno.


MATERIAL AND METHODS
In the years 1994-2001 in Orthopaedics and Traumatology Department in Lublin 33 patients were treated because of 35 fractures of calcaneus (2 bilateral fractures). The comparative material consists of 31 patients treated because of 38 fractures of calcaneus (7 bilateral fractures) in Traumatology and Orthopaedic Department in Krosno in the years 1994-2004. In retrospective study preoperative and postoperative Böhler's angle was measured, as wellas type of fracture was defined according to Essex-Lopresti classification. The clinical results of treatmentwas evaluated with Rowe's classification.


RESULTS
Long-term evaluation was made to all of the patients treated at Orthopaedic and Traumatology Department in Lublin. The follow up is from 5 to 12 years (average 8 years). Clinical results according to Rowe's classification is from 15 to 100 points (average 84.4 pts.). 17 patients treated in Traumatology and Orthopaedic Department in Krosno with closed reduction according to Westhues were evaluated. The follow up is from 2 to 12 years (average 7 years) with the average 52.35 pts in Rowe's classification. The lack of healing of subtalar arthrodesis was observed in one patient, meanwhile osteoarthritis of subtalar joint was observed at 14 patients after closed reduction according to Westhues.


CONCLUSIONS
Closed reduction according to Westhues gives possibility for Böhler's angle restoration, but it does not create the chance for anatomical reduction of articular surface. The considerable percentage of patients suffering pain after Westhues's method testifies about incomplete reduction of articular surface. Open reduction of fracture of calcaneus, combined with simultaneous subtalar arthrodesis restores the correct Böhler's angle and prevents from pain during walking.