Individualized reconstruction plate for treatment of calcaneal fractures via tarsal sinus incision

Abstract

Objective To investigate the clinical efficacy of individualized reconstruction plate in the treatment of calcaneal fractures through the tarsal sinus incision. Methods From May 2010 to September 2012, we treated 46 cases of calcaneal fracture (51 feet) involving talocalcaneal joint. They were 35 males and 11 females, 17 to 65 years of age (average, 35 years). The injury affected the left foot in 24 cases, the right foot in 17, and both feet in 5. By the Sander's classification, 30 feet were type Ⅱ and 21 type Ⅲ. The fractures were reduced through the tarsal sinus incision before internal fixation with individualized reconstruction according to the morphology of fracture. When necessary, fixation with hollow screws was added. The Bohler and Gissane angles were compared between preoperation and postoperation. The clinical efficacy was evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS) system. Results The patients were followed up for 8 to 14 months (average, 12 months). No such complications as incision infection, skin necrosis, plate loosening or exposure occurred in this group. There were significant differences in the Bohler and Gissane angles between preoperation and postoperation [(31.70°±5.50° and 122.10°±6.79° at 3 days postoperation) and (30.95°±3.47° and 122.49°±4.83° at 6 months postoper-ation) versus (6.14°±1.58° and 91.63°±4.76° at preoperation)] (P 0.05). All the patients obtained bony union at 6 months postoperation. According to the AOFAS scores, 38 feet were ex-cellent, 9 feet good and 4 feet fair, giving an excellent to good rate of 92.2% . Conclusion In the treatment of intra-articular calcaneal fractures through the tarsal sinus incision, application of individualized reconstruction plate can lead to fine fracture reduction, rigid internal fixation, early exercise, and decreased incision-related complications. Key words: Calcaneal fracture; Fracture fixation, internal; Bone plates