Epidemiology, Complications, and Surgical Outcomes of Calcaneal Fractures: A Retrospective Single-Center Study in 202 Patients.

Abstract

Background: Calcaneal fractures are complex injuries associated with a high risk of postoperative complications, including infections and wound healing difficulties. Surgical treatment focuses on restoring anatomical alignment and joint congruency, but these fractures remain challenging to manage. The purpose of this study was to assess the epidemiology, postoperative complications, and surgical outcomes, specifically by evaluating changes in Böhler and Gissane angles in patients with calcaneal fractures.

Materials and methods: This is a retrospective single-center cohort study that included 202 patients with 221 calcaneal fractures, 19 of whom had bilateral fractures, treated at Rigshospitalet, Denmark, between 2012 and 2016. Patients were evaluated at 8, 26, and 52 weeks postoperatively. Böhler and Gissane angles were measured preoperatively and postoperatively. Epidemiological data, postoperative complications, and multitrauma cases were recorded.

Results: Of the 221 fractures included, 217 were treated surgically. Among the surgically treated cases, 83% were intra-articular (n = 181) and 17% were extra-articular (n = 36). Twelve patients (6%) had open fractures, and 58 patients (27%) sustained additional trauma-related injuries, with five classified as multitrauma cases. Preoperative Böhler angles averaged 9.4° (range: -20°-40°), improving to 27.7° postoperatively (range: 10°-45°) (p < 0.001). The mean preoperative Gissane angle was 107.4° (range: 52°-147°), improving to 124.1° (range: 102°-147°) postoperatively (p < 0.001).

Conclusion: This single-center study demonstrated significant improvements in Böhler and Gissane angles following surgical intervention for calcaneal fractures. However, postoperative complications, particularly related to soft-tissue management, remain a significant challenge.