الفهرس 
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Abstract
The management of calcaneal fractures is a real challenge for the orthopaedic surgeons. It varies widely and no clear consensus has been reached. Conservative treatment is well accepted for extra-articular fractures and it is based on cast immobilization and early range of motion. Operative management includes open reduction and internal fixation, percutaneous reduction and internal fixation, and the primary arthrodesis. (106)
Since the mid 1990s, several open reduction and internal fixation techniques, of which the extended lateral approach has been applied most frequently, have been considered the gold standard treatment for displaced intra-articular fractures of the calcaneus by most experts. The main disadvantage of the open repair is the high rate of wound complications, which may occur in up to 30% of patients. (73)
The current study was conducted on twenty two displaced intra-articular calcaneal fractures in twenty patients operated at Menoufia University Hospital by closed reduction and percutaneous K-wires fixation during the period from October 2013 to May 2015.
The most common mechanism of injury was fall from height (90.9%). The injury was highest in age group between 25-34 years (45%). It was more commonly seen in males (55%) more than females (45%). Left sided fractures (54.5%) were more common than right sided fractures (45.5%). Calcaneal fractures were associated with other injuries in 31.8% of patients.
CT scan was used to delineate the fracture pattern and for fracture classification. In the current study, according to Sander’s classification,
eleven fractures were type II (50%), nine fractures were type III (40.9%), and two fractures were type IV (9.1%).
The patients were followed up for a mean period of 7.68 (range 6 – 12) months. The average time from injury to operation was 7.2 (range 1 – 21) days. The average operative time was 42 (range 35 – 60) minutes. The mean period of hospital stay was 1.5 (range 1 – 3) days. The maximum hospital stay was 3 days to completely treat the associated injuries.
According to Maryland foot score, the final results at the end of this study were excellent and good in 81.8% of patients, and fair in 18.2% of patients. The mean time of complete radiological union was 11.86 (range 10 – 14) weeks. The mean time of return to full activity was 5.18 (range 4 – 8) months. Regarding complications, only one patient (4.5%) had pin tract infection and no patients developed deep infection. Only one patient developed widening of the heel (4.5%) and no patients developed subtalar osteoarthrirtis till the end of follow up period. In all patients, Bohler’s and Gissane’s angles were restored to the normal range at the time of last follow-up.
There were many factors that affected the end results and were statistically significant as age of the patient, type of fracture, time between injury and operation, presence of associated injuries.