Fixation of intra-articular calcaneal fractures aided by self-designed director for sustentaculum tali screwing

Abstract

Objective To evaluate our self-designed director for sustentaculum tali screwing used to fixate intra-articular calcaneal fractures in comparison with a conventional screwing director. Methods From May 2012 to October 2013, a total of 40 patients received surgical treatment of intra-articular calcaneal fracture at our department. Our self-designed director for sustentaculum tali screwing was used in 20 of them (24 feet, group A) while a conventional screwing director was used in the other 20 patients (22 feet, group B). The 2 groups were compatible in preoperative clinical data, showing no significant differences (P>0.05). The operation time, fluoroscopy frequency, rate of accurate screwing, and Maryland foot scores were compared between the 2 groups. Results The patients were followed up for an average of 15 months (range, 12 to 24 months). Group A had shorter operation time (77.8±9.5 min) than group B (84.4±9.4 min), lower fluoroscopy frequency (2.5±0.9 times) than group B (4.1±1.3 times), a higher rate of accurate screwing (91.7%) than group B (68.2%), and a higher excellent to good rate by Maryland foot scoring (91.7%) than group B (63.6%). The above differences were all statistically significant (P< 0.05). Conclusion In the treatment of intraarticular calcaneal fractures, our self-designed director for sustentaculum tali screwing can significantly enhance the accuracy in fixation of sustentaculum tali to ensure good clinical outcomes. Key words: Calcaneus; Fractures, bone; Fracture fixation, internal; Director for sustentaculum tali screwing