Calcaneus Fracture In Sanglah Hospital
A case report
I Gusti Bagus Arie Mahaputra Budiartha*, I Wayan Subawa**
*Resident of Orthopedic and Traumatology Departement, Sanglah General Hospital, Udayana University, Bali **Staff of Orthopedic and Traumatology Departement, Sanglah General Hospital, Udayana University, Bali
Abstract: Calcaneus fracture management has been a source of controvercy for at least the last century. These fracture present many obstacles to the surgeon. The irregular bony anatomy, the complicated joint mechanics between the tarsal bones, and the delicate soft tissue made these fracture a challenge. Ekstra articular or intra articular fracture have a same chance to do conservative or operative treatment. The complication like wound dehiscence, calcaneal osteomyelitis, post traumatic arthritis, increased heel width, loss of subtalar motion, peroneal tendonitis, sural nerve injury, and chronic pain should be avoided.
Case: A 63 years old patient fell down into a septic tank hole which was under reconstruction with 2 meters depth in kneel position and diagnose with closed fracture left calcaneus intra articular. She also had a closed fracture supracondyler left femur and close fracture right tibia plateu schatzer II. The operation was done 2 weeks after the accident and use a plate screw fixation. The second case 57 years old fell down from a 3 meters tree with stand position. Diagnose with closed fracture left calcaneus intra articular and closed fracture right cruris distal third. she done the others fixation for calcaneus fracture use essex lopresti maneuver after accident. After two different fixation we have the same result there is no wound dehiscense and chronic pain.
Discussion: Significanly better result occurred in patient certain fracture groups undergoing operative treatment. Women, patient with a lighter workload, patient not receiving workers compensation, patient with higher initial Bohler angle (less severe initial injury). Open reduction and internal fixation are generally performed use a thin plate that placed laterally and used as buttress. Good result have been reported for fracture using percutaneous reduction essex lopresti maneuver.
Conclusion: We report two case of calcaneus fracture with the same site, pattern fracture and result but use a different operative treatment which is has successful surgery. Post operative management includes early supervised subtalar range of motion exercises, non-weight bearing for 8 to 12 weeks and good wound care is any factor of the success post operative result.
