Indications and results of the multi-hole GECO plate in the treatment of talar fractures of the calcaneus

Summary

Since 1979, we have fixed certain fractures of the calcaneus with a GECO plate. This is a thin 0.5 mm multi-hole plate. Its value is to provide a support for the screw heads, when the lateral cortex of the calcaneus is fragmented. This is frequently the case, due to sinking of the talus which pushes out the lateral cortex which is broken in several places like an egg shell. The medial cortex on the contrary, more solid, is intact or crossed by a single fracture line. Therefore, while the transverse screws have a good hold in the medial cortex, they do not hold anything laterally, without a wide support, or a plate placed either horizontally, or perpendicular to the talus in the same direction as the trabeculae.

The GECO plate fixes the plate's three trabecular beams with screws at the top of a triangle that will keep its shape, avoiding any secondary deformation of the calcaneus.

193 talar fractures have been fixed with the GECO plate from May 1979 to December 1994. Out of 102 cases reviewed, after 8 months, we found 18 with normal talar movement, 17 partially diminished, 36 greatly diminished, and 31 completely stiff. Our global functional result is within the average of that of the SOFCOT symposium in 1988. Over half our cases are satisfactory: complaining at the most from pain when walking on uneven ground and of difficulties on tiptoe. 4/10 are fair, with pain after one hour walking and an inability to get on tiptoe, as well as a diminution of physical activity, 6.6% are poor.