Open reduction and internal fixation for severely displaced intra-articular calcaneal fractures using calcaneal locking plates

Abstract

Objective To evaluate the clinical outcome of calcaneal locking plates for treatment of the severely displaced intra-articular calcaneal fractures. Methods From October 2006 to December 2007, a total of 21 patients with severely displaced intra-articular calcaneal fractures were treated by open reduction and internal fixation using the ealcaneal locking plates. There were 12 males and 9 females with an average age of 42.5 (24 to 78) years. The left side was involved in 8 cases, and the right side in 13 cases. According to Sanders classification, 12 cases belonged to type Ⅲ, 9 to type Ⅳ. Functional assessment was done using the Maryland Foot Score and plantar pressures were measured with three-dimensional dynamic pedography (F-scan Mobile, Tekscan, USA) . Results Altogether 18 patients got a mean follow-up of 15.5 (10 to 21) months. All of their fractures healed in a mean time of 11.4(7 to 14)weeks without delayed union, nonunion, displacement, avascular necrosis, or failure of screws and plates. The mean Maryland Foot Score for the injured side at the last follow-up was 81.7 (60 to 94). Six feet were excellent, 9 feet good, 3 feet fair, and none poor. The indexes of calcaneal morphology at the last follow-up had a significant im-provement compared with the preoperative ones ( P ＜ 0.05) . The plantar peak pressures of hallucal and metatarsal heads increased and that of the heel decreased ( P ＜0.05), but there was no significant difference in the peak pressure of the midfoot ( P ＜ 0.05). Conclusion The calcaneal locking plates can be used to provide stable fixation with a good functional outcome for the severely displaced intra-articular calcaneal fractures and eliminate most hardware problems and complications. Key words: Calcaneus; Fractures; Fracture fixation, internal; Locking plates