Application Of Poly-axial Calcaneal Locking Plate For Sanders Type â…£ Intra-articular Calcaneal Fractures

Objective: To investigate the clinical outcome of treatment of Sanders Ⅳ intra-articular calcaneal fractures with a poly-axial locking plate.Methods: From January 2012 to July 2014, 17 cases of Sanders Ⅳ intra-articular calcaneal fractures were treated by ORIF with a poly-axial locking plate. There were 14 males and 3 females with a mean age of 34.7 year-old(range, 18~49 years). Regular X-ray were taken for measuring the B!hler’s angle during the follow-up. Overall functional evaluation was carried out according to Visual Analogue Scale(VAS) and American Orthopaedics Foot and Ankle Society(AOFAS) ankle and hindfoot score system. Complications were also recorded.Results: All wounds were healed at the primary stage. 13 patients got follow-up for 12 to 36 months, with an average of 24 months. The X-ray demonstated the bone union at an average 12 weeks(range, 9-16 weeks). The average B!hler’s angle was improved from 12.0±4.2°(5-20°)preoperatively to 33.2±4.6°(26-42°) postoperatively(P<0.05).The mean AOFAS ankle and hindfoot score at the final follow-up was 82.2±5.4(70-90). The mean score of VAS was 1.2±1.0(0-3). 4 patients suffered from subtalar posttraumatic arthritis with a mild pain when walking long distance, which could be relieved by NSAIDs.Conclusions: Treatment of Sanders Ⅳ intra-articular calcaneal fractures with a poly-axial locking plate could obtain a stable fixation and an acceptable clinical outcome, which is a safe and effective method.