| ABSTRACT Objective Review our series of open calcaneal fractures, to discuss the clinical outcome and evaluate the effect factors associated with the prognosis. Methods Between 2004 and October 2009, 427 calcaneal fractures were treated at our hospital, and 22 of these fractures in 22 patients were open, 15 feet of 15 patients were available for follow-up. According to the Sanders classification there were 2 type-Ⅰ, 3 type-Ⅱ, 6 type-Ⅲ and 4 type-Ⅳ. According to the Gustilo classification there were 1 type-I, 4 type-II, 5 type-IIIA, and 5 type-IIIB open fracture. According to the Open Calcaneal Injury Subtypes(OCIS), there were 1 type-ⅠA, 2 type-ⅡA, 7 type-ⅡB, 2 type-ⅢA and 3 type-ⅢB. All patients were treated with intravenous antibiotics, immediate and repeat irrigation and debridement, temporary wound coverage, and initial stabilization of the limb. clinical examination, radiographs and AOFAS ankle-hindfoot scores were used for outcome measurement. Results The average time of follow-up was 16.4 months (8~31 months). The mean AOFAS score was 74.6(range 58~94). There were 4 feet required tissue transfer for wound coverage. An infection developed at the sites of 5 fractures, 4 of witch were Gustilo type-Ⅲ, 2 deep infections with osteomyelitis developing at the site of 1 patient, no patient required amputation. Conclusions Our findings do not reflect as high a deep infection and osteomyelitis rate for open calcaneal fractures as previously reported, if early and satisfying debridement, evaluate the soft tissue injury carefully, and choose the right time and indications for internal fixation. In addition, early internal fixation should be avoided for Gustilo type-Ⅲ and OCIS type-B calcaneal fractures. |
