Publication:

Prospective study of fracture calcaneus with Allan’s procedure- bone grafting without implants

Background Calcaneum is usually fractured following high energy axial traumas such is seen in cases of fall from height or road traffic accidents. If not properly managed these fractures can be a cause of prolonged morbidity in the form of pain, stiffness and deformities. We have conducted this prospective study of fracture calcaneum with the method described by Allan et al which constitute of open reduction and bone grafting without any implants. The objective of the was to determine the clinical approach, described by Allan et al for treatment of fracture calcaneum and to discuss in short the results, pitfalls and challenges associated with this.

Methods A prospective study was done on 42 patients who were diagnosed with intra-articular calcaneal fractures depending upon a predefined inclusion and exclusion criteria. All fractures of the study subjects were treated using a lateral approach by Allan’s procedure. Final outcome was assessed on the basis modified Rowe score.

Results In this study a total of 42 patients with intra-articular calcaneal fractures and treated by open reduction and bone grafting without any implants were studied. There were 36 men and 6 women. Majority of the patients tolerated the procedure well and most of the patients (95.23%) had a complete or partial restoration of heel shape. Significant residual pain was seen in only 1 (2.38 %) patient. 36 patients (85.71 %) had excellent outcome 5 patients (11.90%) had good and 1 patient (2.38%) had satisfactory outcome.

Conclusions The management of intra-articular calcaneal fracture by open reduction and bone grafting without any implants give good results with excellent functional outcome. Since no implants are used in this technique this can be a preferable procedure in rural areas and in patients with low socioeconomic status.