The Clinical Effectiveness Of Anatomic-locking Plate To Fix Intra-articular Calcaneal Fractures

Objective To evaluate the clinical effectiveness of Anatomic-lockingplate(ALP) to fix intra-articular calcaneal fractures.Methods Between May2010and August2012,36cases ofintra-articular calcaneal fractures were treated. There were31males and5females with an average age of39.4years (range from15to59years).According to Sanders classification system, there were8cases of type II,24cases of type III, and4cases of type IV. Open reduction and internalfixation with Anatomic-locking plate combined with bone grafting wereperformed. Radiological Assessment was done by Bohler’s angle andGissane’s angle along with measurement of calcaneal height. Functionaloutcome was assessed using the Maryland Foot Score.Results36cases were followed up14months on average (range from12to20months). One patient had superficial infection and was cured afterlocal wound care, changing dressings with povidone iodine andanti-infection;One had flap necrosis at incisional edge and was cured bydebridement and anti-infection;There was one patient with delayed healing and dehiscence of incision,and was cured by changing dressings andclosing the incision in the second stage; Breakage of plate was seen in onepatient at6months after operation without lose of reduction; One screwbreakage occurred in one case when removing the internal fixation at oneyear after operation, no screw loose or displacement; One case had bilateralsubtalar joint fusion spontaneously after operation, no pain when walking.No subtalar arthritis，no sural nerve injury or irritation of peroneal tendonoccurred during follow-up. The Bohler’s angle, Gissane’s angle andcalcaneal height were (5.80±10.80)°，(107.10±10.81)°and（41.87±4.27）mm respectively at preoperative，which were improved to(21.61±8.30)°，(120.26±12.88)°and （47.77±4.30） mmrespectively at1week after operation；At follow-up of one year afteroperation, the Bohler’s angle was (21.57±8.35)°,the Gissane’s angle was(120.24±12.93)°,calcaneal height was（47.70±4.34）mm. Significantdifference was found between preoperative and1week after operation（P＜0.05），But no Significant difference between1week after operation and1year after operation（P＞0.05）.Maryland Foot Score showed29cases gotexcellent result,6cases good,1case fair,no poor result, the excellent andgood rate was97.2%.Conclusion Treatment of intra-articular calcaneal fracture withAnatomic-locking plate and bone grafting can obtain good clinicaloutcomes.