External fixation with supercutaneous calcaneal locking plate for displaced intra-articular calcaneal fractures

The purpose of this study was to retrospectively evaluate patients who had open reduction and external fixation of displaced intra-articular calcaneal fractures with supercutaneous calcaneal locking plates used as external fixators.

Between October 2007 and June 2009, 25 cases were performed. According to the Sanders classification system, 17 cases were type IIA and there were two cases each of type IIB, type IIC, type IIIAC, and type IV. Three months after surgery, when imaging studies confirmed bone union, the plates and screws were removed in the outpatient clinic. The average time of follow-up was 36 (range, 33 to 48) months.

Two cases (8%) had superficial wound necrosis and no pin tract infections were noted. The reduction of the articular surface and bone union were good. Two cases of type IIA developed lateral wall exostosis, which resulted in peroneal tendinitis. The preoperative x-rays of the 25 patients had an average Böhler's angle of 12° ± 9° and Gissane's angle of 87° ± 8°. Their postoperative x-ray films demonstrated that the Böhler angle improved to 30° ± 7° and the Gissane angle to 116° ± 7° (p < .01). According to the Ankle-Hindfoot Clinical Rating System of the American Orthopaedic Foot and Ankle Society (AOFAS), their average score was 91 (range, 68 to 100) points.

Using a supercutaneous calcaneal locking plate to treat calcaneal fractures caused limited tissue irritation, a low rate of local skin infection, satisfactory reduction of the articular surface, stable fixation, and an overall reduced cost.