The treatment of displaced intra-articular calcaneal fractures by "/\" shape incision with compression fixation and stud bolts

Abstract

Objective To explore the method and efficacy of the treatment for displaced intra-articular calcaneal fractures by lateral / shape with compression fixation and stud bolts.Methods From August 2010 to November 2011,used the lateral / shape incision,namely the straight front of achilles tendon and the sinus tarsi oblique incision,140feet with displaced intra-articular calcaneal fractures in 130 patients were treated with calcaneal anatomical plate and compression fixation with stud bolts.There were 117 males and 13 females,with an average age of 42.3 years.According to Sanders classification,the fracture patterns include 49 cases for type Ⅱ,75 for type Ⅲ,and 16 for type Ⅳ.The B（o）hler and Gissane angle as well as the varus angle,the displacement of subtalar articular surface,the width,height and length of the calcaneum were measured on pre-and post-operative radiographs.The Maryland and AOFAS foot score were used to assess the results.Results One hundred and thirty patients got followed up with an average of 20 months (range,15-31 months).There were no edge necrosis and wound infection.The time of fracture union was 54.51 ±20.38 d (range,45-86 d).The amount of bleeding was 194.24±104.17 ml.Accorrding to the preoperative and postoperative radiographs,the mean B(o)hler angle was 6.27°±11.81° and 27.21°±8.28°; the mean Gissane angle was 108.36°±21.77° and 117.47°±12.93°,the mean calcaneal width was 47.35±5.85 mm and 35.96±4.14 mm,the mean calcaneal height was 39.79±5.85 mm and 47.64±3.83 mm,the mean calcaneal length was 78.30±5.81 mm and 79.41±5.30 mm.Based on the Maryland foot score,the excellent and good rate was 92.86％ (130/140).Based on the AOFAS foot score,the excellent and good rate was 95.71％ (134/140).Compared with the normal side,the ankle varus of 12feet were restriction for 5°-8°,3 feet were sufferd for subtalar arthritis.Conclusion Lateral / shape incision with compression fixation and stud bolts to is a safe and effective method for the treatmeat for the displaced intra-articular calcaneal fractures,significantly reducing and avoiding the wound complications,restoring calcaneal anatomical morphology and the surface of subtalar joint.The compression fixation with stud bolts is reliable and stability,it can promote the early healing of fractures. Key words: Calcaneus; Fractures bone; Fracture fixation, internal