[Osteosynthesis of articular fractures of the heelbone using a reconstruction plate]

The authors describe in detail this technique which employs a reconstruction plate which can be moulded in all directions. The plate, fashioned in a stereotyped way extemporaneously or even during the pre-operative period, perfectly fits the lateral surface of the calcaneus, curves behind the tuberosity and descends in front to the junction of the lateral and inferior surfaces of the greater apophysis. With its screws anchored in the sustentaculum tali, it supports the previously reduced thalamic body which is itself fixed to the sustentaculum by screws, thereby avoiding further slippage. The very solid union thus obtained allows early weight bearing. This technique allows logical treatment of all types of fractures. Numerous technical details provide surgical guidelines for these technically difficult fractures. The operating protocol may thus be used by all operators. There are plans to market a pre-moulded plate which would further simplify the procedure. Currently, 55 fractures have been treated by this technique. The median interval to weight bearing was 7 days and 6 weeks to walking without crutches (45 cases). The functional results in 34 cases with sufficient follow-up (16 Months) showed 71% satisfactory results (very good, good or quite good), 21% mediocre and 8% poor results.