Comparison between normal anatomic plate with bone graft and locking plate in treatment of calcaneal fractures of Sanders types II & III

Abstract

Objective To compare the clinical efficacy between calcaneal anatomic plate + autologous bone graft and calcaneal locking plate in treatment of calcaneal fractures of Sanders types Ⅱ & Ⅲ. Methods The current study recruited 68 cases of calcaneal fractures of Sanders types Ⅱ & Ⅲ who had been treated in our hospital from August 2010 to December 2013. The patients were treated either by ordinary calcaneal anatomic plate plus autologous iliac bone graft (36 cases) or by calcaneal locking plate (32 cases). The general clinical data were compatible between the 2 groups (P< 0.05). The 2 groups were compared in terms of operation time, postoperative drainage, hospital stay, non-bearing ambulant time, full bearing time, postoperative complications, Bohler angle, Gissane angle, the length, width and height of the calcaneus, and the Maryland scores of the foot function. Results All the patients achieved fine fracture union without postoperative infection, skin necrosis or wound dehiscence. There was no significant difference between the 2 groups in incidences of postoperative calcaneal pain or calcaneofibular impingement syndrome (P>0.05). The bone graft group needed significantly longer operation time, non-bearing ambulant time and hospital stay than the locking plate group (P 0.05). There were significant differences between pre-operation and one year post-operation in Bohler angle, Gissane angle, and the length, width and height of the calcaneus (P 0.05). The 2 groups showed insignificant differences in the Maryland scores of the foot function either (P>0.05). Conclusion In treatment of calcaneal fractures of Sanders type Ⅱ and Ⅲ, compared with ordinary plate + autologous bone graft, locking plate without bone graft may reduce the incidences of post-operative pain caused by iliac bone graft, infection, hematoma, and other complications but shows no obvious advantages in calcaneal reduction or foot function. Key words: Calcaneal fractures; Fracture fixation, internal; Bone plates