STUDY OF OCCURRENCE, DEMOGRAPHY AND PATHOMORPHOLOGY OF ANKLE AND FOOT FRACTURES AND EVALUATION OF THE TREATMENT OUTCOME OF CALCANEAL FRACTURES

Abstract: Background: This study highlights which injury has greatest burden, how frequent are the injuries of foot and ankle areas, which is an extremely neglected specialty in orthopedics and also the importance of proper diagnosis, classification of fractures, appropriate pre-operative planning and timely conservative as well as surgical intervention of ankle and foot fractures that resulted in a satisfactory outcome Despite the fact, foot and ankle is the most important locomotor unit of our lower limb, there have been few studies addressing the problem and treatment outcome of such fractures. Objective : To determine the occurrence, demography and pathomorphology of ankle and foot fractures, also evaluation of treatment outcome of calcaneal fractures. Methodology : This was a longitudinal interventional study which dealt with acute traumatic ankle and foot fracture patients coming to Accident and Emergency Department of MHL, DOST unit 1, with inclusion and exclusion criteria clearly defined. Results : Total 100 patients were included in the study. Mean age of patients was 35.71±13.60 years. Minimum age of patients was 14 and maximum age of patients was 70 years respectively. Gender distribution of patients shows that 15 patients were female and the remaining 85 patients were male. Male patients were greater in number as compared to female patients ie. M: F, 6:1. Mechanism of the injury showed that there were 48 patients who suffered from RTA , 37 patients had trauma due to fall from height, 6 patients had industrial injuries, 5 patients had Fire Arm Injury, and 2 patients had injuries due to domestic activity, 1 had trauma due to sports activity and 1 had injury due to agricultural work. There were 41 patients with fractures of calcaneum and out of which 5 had bilateral fracture calcaneum. They were classified according to CT based Sanders classification. Out of these 22 patients were of Sanders type III, 12 patients were of Sander type II, 5 patients were of Sander type IV, 2 patients were of Sander type I. Sander type I were treated conservatively with Boot cast, Sanders type II and III were treated with boot cast and Percutaneous Stiemann pin, K-wire and malleolar screws, while Sander type IV treated conservatively due to severe communication with subsequent Tripple Arthrodesis if required. Conclusion: This study highlights the burden of foot and ankle injuries as well as the importance of proper diagnosis, classification of fractures, appropriate pre-operative planning and timely intervention of Ankle and foot fractures. Foot and ankle is the most important locomotor unit of our lower limb and this is a neglected specialty in our society which needs special attention and care for the welfare of patients by expertise. Outcome assessment of ankle and foot patients was done by Olerud-Molander scoring system. Patients with follow up of at least 8 months were called by phone to complete the functional scoring system (Olerud-Molander). According to this criteria 5 patients had excellent outcome, 42 had good outcome, 43 had fair and 10 patients had poor outcome. Key words: Ankle and Foot Fractures, Calcaneal Fractures, HSS