Minimally invasive three-window incision and novel anatomical locking plate for treatment of calcaneal fractures / 中华创伤骨科杂志

ABSTRACT

Objective:To investigate the efficacy of a minimally invasive three-window incision and internal fixation with a novel anatomical locking plate in the treatment of calcaneal fractures.Methods:A retrospective analysis was performed of the 46 patients with calcaneal fracture (Sanders typeⅡ and Ⅲ) who had been admitted to Department of Orthopedics, Luoyang Orthopaedic Hospital of Henan Province from February 2015 to May 2017. They were 22 males and 24 females, aged from 19 to 59 years (average, 39.0 years) and with 16 left and 30 right sides affected. They were all treated with a minimally invasive three-window incision and internal fixation with a novel anatomic locking plate. Their B?hler and Gissane angles, and height, width and length of the calcaneus were compared between preoperation, immediate postoperation and the last follow-up. Their ankle-hindfoot functions were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring scale at the last follow-up; their complications were recorded.Results:All the 46 patients were followed up immediately after operation and for 14 to 18 months (mean, 16 months). All the fractures achieved bony union after an average of 3 months (from 2 to 4 months). At immediate postoperation and at the last follow-up, their calcaneal B?hler angles (34.20°±3.62° and 34.05°±3.65°) and Gissane angles (131.45°±6.04° and 131.25°±5.88°), and calcaneal heights [(41.05±2.76) mm and (40.90±2.86) mm], widths [(25.65±1.53) mm and (25.55±1.64) mm] and lengths [(76.82±1.70) mm and (76.73±1.78) mm] were significantly improved compared with the preoperative values [10.55°±7.51°, 95.32°±12.16°, (26.10±4.54) mm, (37.71±3.42) mm and (65.91±2.10) mm] ( P<0.05). There were no significant differences in the above indexes between immediate postoperation and the last follow-up ( P>0.05). According to AOFAS ankle-hindfoot scores at the last follow-up, the efficacy was evaluated as excellent in 28 cases, as good in 12 cases and as fair in 6 cases, yielding an excellent and good rate of 87.0%. No incision infection occurred after operation. Conclusion:In the treatment of calcaneal fractures of Sanders type Ⅱ and Ⅲ, the minimally invasive three-window incision and internal fixation with the novel calcaneal anatomical locking plate can achieve satisfactory reduction and rigid fixation, effectively reducing postoperative incision complications.