Relationship between the efficacy of using plate for intra-articular calcaneal fractures and calcaneal anatomical angles

Abstract

Objective To observe the efficacy of using plate for intra-articular calcaneal fractures, and to explore the relationship of the efficacy with Bohler's angle and Gissane's angle before and after operation. Methods From January 2001 to August 2007, 55 cases 65 feet with calcaneal fractures,including Sanders type Ⅱ 16 feet, type Ⅲ 22 feet and type Ⅳ 27 feet, which received open reduction and internal fixation with calcaneal plates were followed-up for(33.9±13.9) months ( range 15 to 68 months ). The efficacy was validated according to the score criterion designed by Kerr. At the same time, the Bohler's angle and Gissane's angle were measured before and after operations. Then, multivariate regression analysis was applied to evaluate the relationship between recovery scores and angles degrees. Results The overall average recovery score was 83.5±12.4 after operation, and the excellent and good rate was 86.2%. In addition, the average recovery scores of Sanders type Ⅱ, type Ⅲ and type Ⅳ were 91.5±9.5,82.5±14.4 and 79.5± 10.1 respectively,and the excellent and good rates were 100% ,81.8% and 81.5% respectively. Multiple linear regression analysis showed that the Bohler's angle before operation, Bohler's angle after operation and the difference of postoperative and preoperative Bohler's angle were positive determinants of the postoperative recovery score( all P 0.05 ). Conclusions Internal fixation with calcaneal plate for intra-articular calcaneal fracture is a good method for restoration of function early after operation. Bohler's angle can be used as an indicator of clinical efficacy. Gissane's angle is not an effective clinical indicator. Key words: Calcaneus; Fracture fixation; internal; Bohler's angle; Cissane's angle