Comparison of uniaxial and polyaxial locking plate fixation for Sanders types Ⅳintra-articular calcaneal fractures / 中国医师进修杂志

ABSTRACT

Objective To compare the radiographic and clinical outcomes of uniaxial and polyaxial locking plates used in the treatment of Sanders types Ⅳ intra-articular calcaneal fractures. Methods A retrospective comparative study was performed on the 72 patients with Sanders types Ⅳintra-articular calcaneal fractures who had been treated by uniaxial locking plates (A group, 38 cases) or polyaxial locking plates (B group, 34 cases) between January 2012 and December 2016. Operation time, intraoperative bleeding, union time, radiological and functional outcomes and functions by the Maryland foot score were compared between the two groups. Results There were no significant differences between the two groups in operation time, intraoperative bleeding, or union time (P>0.05). The patients in A group were followed up for (23.2 ± 5.4) months, and those in B group were followed up for (22.5 ± 4.9) months. All the patients obtained bony union. B group displayed significantly better Bohler angles [(31.6 ± 4.5)° vs. (27.6 ± 6.1)°, (30.7 ± 4.2)° vs.(27.0 ± 5.4)°] and Gissane angles [(109.2 ± 10.8)° vs. (96.8 ± 9.5)°, (107.3 ± 10.1)° vs. (95.4 ± 10.2)°] at 3 and 12 months after operation , compared with A group (P<0.05). Evaluated by the Maryland foot score, the excellent and good rate for the B group was 91.2％(31/34) , which was insignificantly higher than that for the A group (84.2％, 32/38) (P > 0.05). Conclusions Both uniaxial locking and polyaxial locking plates can lead to satisfactory therapeutic outcomes for Sanders types Ⅳ intra-articular calcaneal fractures, but polyaxial locking plates may be superior in stability and functional recovery.