Locking calcaneal plate: A reliable way in treating displaced calcaneum fractures

Author(s): Dr. Gautam Chandra Paul and Dr. Ujjal Rajbangshi

Abstract: Introduction: Calcaneum fracture are more commonly in male specially in industrial workers. It is more commonly in age group of 21-45 years. Fracture of calcaneum have more attention because a large number involves the subtalar joint and frequently lead to chronic pain and osteoarthritic changes. Materials and Method: In this descriptive study we took fifteen patients with seventeen of displaced intraarticular calcaneum fracture. After preoperative and radiological investigation, open reduction and internal fixation carried out with calcaneal plate with lateral approach. After anatomical reduction with the help of k wire and intraoperative C-arm images locking calcaneal plate was fixed with screws. All 15 patients were followed up for a mean duration of 12 months. Final evaluation was done according to Bohler’s angle, Gissane’s angle and AOFAS (American Orthopaedic Foot Ankle Society) score.
Results: All the patients achieved radiological fracture union at a duration of 12 to 14 weeks. At final follow up the, the mean AOFAS score is 90.83±5.45 for Sander’s type II fracture and 86.45±6.97 for Sander’s type III fracture. The Bohler’s angle improved from preoperative 5.59˚±8.45˚ to postoperative 24.29˚±5.56˚, Gissane’s angle improved from preoperative 155.29˚±6.95˚ to post operative 132.94˚±6.13˚.
Discussion: Operative and non-operative management have both been suggested for acute treatment of calcaneal fracture, however it is generally accepted that in most cases operative treatment of displaced calcaneal fracture is warranted in order to avoid the negative consequences of malunion. Both medial and lateral approaches have been used, but the lateral approach allows direct exposure of articular surface, while the medial approach is limited to reduction of the body.
Conclusion: Timing of surgery is one of the most important determinants for the outcome of treatment and determined by subsidence of edema and appearance or wrinkle sign. Operative treatment with calcaneal plate gives a good outcome, even when bone graft is not used.

DOI: https://doi.org/10.22271/ortho.2022.v8.i1i.3086