Comparison of Clinical Results Between Locking Plate Fixation and Screw Fixation for Intra-Articular Calcaneal Fractures

Abstract

Category: Trauma; Hindfoot Introduction/Purpose: The purpose of this study is to compare the results of the two fixation groups for intra-articular calcaneal fractures based on the hypothesis that the locking plate group (P-group) can have a less corrective loss but smaller range of motion due to soft tissue contracture than the screw alone group (S-group). Methods: P-group included ten feet, five feet of which were categorized as Sanders classification type 2, four as type 3, one as type 4. S-group included 11 feet, nine as type 2, two as type 3. In both groups, small incisions such as sinus tarsi approach were used, and P-group was fixed with a locking plate, and canulated cancellous screws if necessary, while S-group was fixed with canulated cancellous screws only. We assessed range of motion of the ankle joint and subtalar joint, Creighton-Nebraska scale (CN scale) and pre- and postoperative width and height of the calcaneal body and step of subtalar joint surface. Results: The mean postoperative range of motion in the P-group / S-group was 15°/46.2° / 13.2°/45.9° for ankle dorsiflexion/plantarflexion, and 5°/13° / 5.5°/16° for subtalar joint eversion/inversion, respectively. The mean postoperative clinical score was 89.8+-9.5 points / 93.9+-8.0 points on the CN scale, and the mean pre- and postoperative imaging evaluation showed improvements in the mean width from 120.7+-8.9% to 107+-6.7% / 122.6+-13.4% to 112.9+-10.7%, in the mean height from 88.7+-4.6% to 97.8+-3.3% / 88.3+-5.8% to 99.4+-5.3%, and in the mean step of subtalar joint surface from 6.2+-5.3 mm to 0.7+-1.1 mm / 10.5+-7.6 mm to 1.5+-2.5 mm. As complications, peroneal tendinopathy and transient peroneal neuropathy were observed in one case each in the both groups. Conclusion: There was no significant difference between the two groups in the corrective loss and postoperative range of motion.