Gait analysis and functional assessment of conservatively treated calcaneal fractures.

Objectives: This study aims to compare the functional scores and gait analysis data of patients undergoing conservative treatment after calcaneal fractures with healthy individuals and to evaluate both success of conservative treatment and the applicability and effectiveness of a novel smartphone-based gait analysis method in assessing post-fracture mobility.

Patients and methods: Between January 2017 and December 2022, a total of 30 patients (10 females, 20 males; mean age: 48.6±12.6 years; range, 19 to 65 years) who underwent conservative treatment due to calcaneal fractures and 30 healthy controls (12 females, 18 males; mean age: 45.3±12.7 years; range, 21 to 63 years) were retrospectively analyzed. Patients with completed fracture union and mobilized by full weight bearing on the fractured extremity were evaluated with ankle joint range of motion (ROM), American Orthopaedic Foot and Ankle Society (AOFAS), Short Form-36 (SF-36), Visual Analog Scale (VAS) functional scoring and gait analysis using the smartphone-based Gait Analyzer application, and the results were compared with the control group.

Results: After conservative treatment, there was no statistically significant difference in the ankle ROM values (dorsiflexion p=0.359, plantarflexion p=0.240), AOFAS (p=0.211), and SF-36 scores (physical function p=0.188, pain p=0.483, health change p=0.894) of the patient and control groups. The mean VAS score of the patient group was 2.83±1.80, indicating higher scores than those of the control group (p=0.035). There was a statistically significant change between the groups in terms of all gait parameters (gait velocity p=0.010, step time p<0.001, step length p<0.001, cadence p<0.001, step time symmetry p<0.001, step length symmetry p<0.001, vert-COM p<0.001).

Conclusion: Although the functionality and gait patterns of the patients may be affected after conservative treatment of calcaneal fractures, the fact that there was no significant difference between the patient and control groups indicates that this treatment method can be preferred in this group of patients, particularly in extraarticular and Sanders type 1 intra-articular fractures, with appropriate rehabilitation.