Open Access, Peer-reviewed, Quarterly
pISSN 1225-1682
eISSN 2287-9293
    J Korean Fract Soc. 2010 Jul;23(3):303-309. Korean.
    Published online Jul 31, 2010.
    https://doi.org/10.12671/jkfs.2010.23.3.303
    Copyright © 2010 The Korean Fracture Society
    Original Article

    Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture

    Myung Jin Lee, M.D., Sung Keun Sohn, M.D., Kyu Yeol Lee, M.D., Sung Soo Kim, M.D., Min Soo Kang, M.D.,* Hyeon Jun Kim, M.D, and Sang Kyu Sun, M.D.
      • Department of Orthopedic Surgery, College of Medicine, Dong-A University, Busan, Korea.
      • *Department of Orthopedic Surgery, Dong-Eui Medical Center, Busan, Korea.
    • Address reprint requests to: Hyeon Jun Kim, M.D. Department of Orthopedic Surgery, College of Medicine, Dong-A University, 1, Dongdaesin-dong 3-ga, Seo-gu, Busan 602-715, Korea. Tel: 82-51-240-5167, Fax: 82-51-254-6757, Email: campbellkim@naver.com
    Received November 19, 2009; Revised March 04, 2010; Accepted April 07, 2010.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Purpose

    To evaluate the surgical outcomes of open reduction and internal fixation of AO calcaneal plate in displaced intra-articular fractures of the calcaneus.

    Materials and Methods

    From January 2004 to July 2007, 25 patients with 27 displaced intra-articular calcaneal fractures were treated by open reduction and internal fixation using the AO calcaneal plate. Preoperative, postoperative evaluations and a follow-up after 1 year were done radiologically by the Böhler angle, Gissane angle, heel height and width among all patients. Their functional status was assessed by means of the Maryland foot score.

    Results

    The mean Böhler angle, Gissane angle, heel height and width were restored comparing with preoperative data. However, in Sanders type IV, some losses of reduction occurred at 1 year follow-up (p<0.05). The mean Maryland foot scores were 85 points in type II, 82 points in type III and 63 points in type IV. Sanders types significantly affected the clinical results (p<0.05).

    Conclusion

    The AO calcaneal plate fixation using extensile L-shpaed lateral approach shows satisfactory radiologic and clinical results in the treatment of displaced intra-articular calcaneal fractures.

    Keywords
    Calcaneus; Intra-articular fracture; Internal fixation; AO calcaneal plate

    Figures

    Figure 1
    A 21-year-old female patient sustained left intra-articular calcaneal fracture by slip down.

    (A) Preoperative X-ray shows tongue type intra-articular calcaneal fracture.

    (B) Preoperative axial and sagittal CT scans show Sanders type IIb calcaneal fracture.

    (C) Postoperative X-ray shows restoration of Böhler angle and heel width.

    (D) At follow-up of 13months, X-ray shows no subtalar joint arthritis.

    Figure 2
    A 45-year-old male patient sustained right open comminuted intra-articular calcaneus fracture by fall down from 6 meter height.

    (A) Preoperative X-ray shows joint depression type intra-articular calcaneal fracture with negative Böhler angle.

    (B) Preoperative semicoronal and 3D CT scan shows Sanders type IV calcaneal fracture.

    (C) Postoperative X-ray shows restoration of Böhler angle and stable fixation.

    (D) Postoperative X-ray shows varus change of heel and malunion of calcaneus and losses of corrections.

    Tables

    Table 1
    Summary of radiologic parameters

    Table 2
    The relationship between Sanders type and Maryland foot score (Linear by linear association)

    Table 3
    The relationship between preoperative Böhler angle and Maryland foot score (Fisher's exact test)

    Table 4
    The relationship between associated injury and Maryland foot score (Fisher's exact test)

    Table 5
    The relationship between financial compensation and Maryland foot score (Fisher's exact test)

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    MeSH Terms
    Calcaneus
    Follow-Up Studies
    Foot
    Heel
    Humans
    Intra-Articular Fractures
    Maryland
    Metrics
    Share
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