Fixation for calcaneal tuberosity fracture (beak fracture) using preformed "L-shape" hook plate

Surgical management of calcaneal tuberosity fractures is challenging, as patient outcomes can be compromised by skin flap necrosis and implant failure. We propose a technique utilizing a prefabricated L-shaped hook plate, which represents an innovative clinical orthopedic surgical approach.

In this retrospective study, patients with Beavis type II calcaneal tuberosity fractures underwent internal fixation using a preformed "L-shape" hook plate (2015-2020). Data on operative time, complications, and healing time were recorded. Functional outcomes were evaluated using the Ankle Society Ankle-Hindfoot (AOFAS-AH) and Visual Analog Scale (VAS) pain scores.

This study included 15 patients (6 females/9 males; mean age 52.9 ± 11.2 years) with calcaneal tuberosity fractures who underwent internal fixation with a preformed "L-shape" hook plate. At a mean follow-up of 17.1 ± 6.0 months, no postoperative complications-including wound issues, infection, nerve injury, or fixation failure-were observed in any patient. All 15 cases achieved clinical healing at an average of 10.5 weeks (range: 8-13). Functional outcomes improved significantly, with the AOFAS-AH score increasing from 24.0 ± 9.9 preoperatively to 93.8 ± 5.2 postoperatively, and the VAS score decreasing from 5.7 ± 0.6 to 1.3 ± 0.5 (p < 0.001 for both).

Emergency open reduction and internal fixation is recommended for calcaneal avulsion fractures to prevent flap necrosis. For Beavis type II fractures, the preformed L-shaped hook plate represents a novel and promising alternative, demonstrating favorable early clinical outcomes in this initial series.