Gait assessment in patients with intra-articular calcaneal fractures after treatment with the Ilizarov method

Abstract

Background

Intra-articular and comminuted fractures of the calcaneus constitute a significant orthopedic challenge. Calcaneal fracture management should primarily aim to achieve good clinical and biomechanical outcomes, pain reduction, and normal function following treatment.

Research question

How does Ilizarov treatment of calcaneal fractures affect gait parameters?

Methods

This retrospective study included 21patients (7 women, 14 men) who were treated for intra-articular calcaneal fractures with the Ilizarov method in the period 2021–2022. Nineteen healthy volunteers constituted the control group. Gait assessments were conducted with a BTS G-SENSOR device (BTS Bioengineering Corp., Quincy, MA, USA). The gait assessment evaluated the following parameters: assessment duration expressed in seconds (s), cadence expressed as the number of steps per minute (steps/min), gait velocity (m/s), stride length (m), stance phase (%), swing phase (%), double support phase (%), and single support phase (%).The study assessed pain intensity in the VAS scale, Böhler's angle and Gissane's angle.

Results and Significance

We observed no significant differences between the experimental group and the healthy control group in terms of cadence, gait velocity, or stride length. Patients in experimental group showed significantly shortened stance and single support phases in the treated limb in comparison with those in the intact limb; the remaining gait parameters were similar in the treated and intact limb. We observed no significant differences between the treated limbs in the patient group and the nondominant limbs in the control group in terms of any gait parameters. In the follow-up, the average pain value on the VAS scale was 2.3. The median Böhler angle changed from 5.5° preoperatively to 28.5° postoperatively, p < 0.001. The median Gissane's angle was 119° before surgery and 143° after surgery, p < 0.001.The use of the Ilizarov method in the treatment of calcaneal fractures helps achieve sufficient normalization of most gait parameters, with their values similar to those observed in healthy volunteers. After treatment of calcaneal fractures using the Ilizarov method, radiological parameters improved. The biomechanical outcomes of calcaneal fracture treatment with the Ilizarov method are good.