Application of locking compression plate in treatment of calcaneal fractures / 中华骨科杂志

ABSTRACT

Objective To evaluate the clinical effect of the treatment for calcaneal fractures by locking compression plate.Methods From January 2008 to December 2011,30 patients with 40 calcaneal fractures were operated with locking compression plate.There were 25 males (33 feet) and 5 females (7 feet) with an average age of 44.8 years (range,22-60 years).Fifteen feet were on the left side,and 25 feet were on the right side.All patients had closed fractures,with complicated spinal injury in 2 patients.According to Sanders classification,20 feet were type Ⅱ[fractures,15 feet were type Ⅲ,and 5 feet were type Ⅳ.The lateral approach was adopted for all the patients in the treatment in which locking compression plate fixation was used but no external fixation.Early and suitable rehabilitation was carried out postoperatively.The patients could bear part of the loading six weeks after the operation and all the loading twelve weeks after the operation.The results were validated using the Anerican Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale.Results The patients were followed up for 8-20 months (average,12 months).Bone union occurred in all cases with roentgenographic evidence during 8-12 weeks postoperation (average,10 weeks).None of the patients had such complications as nerve injury or osteomyelitis.Incision dehiscence occurred in one case in which a little part of titanium plate and screw was exposed,but the incision was healed by dressing 1 month later.Two patients had subtalar arthritis and suffered from the pain while walking.Of the two patients,the pain was relieved for one after the operation of subtalar joint fusion,and the other was lost to the follow-up after he or she refused further treatment for economic reasons.According to AOFAS foot score standard,the effects of 20 cases were excellent,17 were good,and 3 were fair.The excellent and good rate was 92.5％.Conclusion The application of locking compression plate is an effective and satisfied treatment of calcaneal fractures which is beneficial for healing and functional exercise.Moreover,the rate of soft tissue complication after operation is low.