[Treatment of intra-articular calcaneal fracture by bone grafting and plastic ti-alloy plate internal fixation].
OBJECTIVE
To investigate the therapeutic effect of open reduction, bone grafting, and internal fixation with plastic ti-alloy plate on intra-articular calcaneal fracture.


METHODS
From January 2005 to December 2007, 32 patients (37 feet) with intra-articular calcaneal fracture underwent open reduction, bone grafting of autogeneic ilium (30-80 g) and internal fixation of plastic ti-alloy plate. There were 21 males and 11 females aged 18-56 years old (average 42.1 years old). There were 5 cases of bilateral calcaneal fracture and 27 cases of unilateral calcaneal fracture, including 2 cases of open fracture and 30 cases of close fracture. According to Sanders classification system, there were 11 cases of type II, 18 cases of type III and 8 cases of type IV. Preoperatively, Böhler angle was (-9.6 +/- 4.2) degree and Gissane angle was (101.4 +/- 10.6) degree. Nine feet underwent emergency operation and 28 feet received operation 5-7 days after injury.


RESULTS
The wounds of 34 feet healed by first intention. The wound margin of 3 feet was gray with a small amount of colorless exudates, and healed after dressing change. All patients were followed for 12-24 months (average 16 months). X-ray films displayed that the fracture all healed within 3-4 months after operation. At 6 months after operation, the Böhler angle and the Gissane angle was (28.5 +/- 6.1) degree and (128.9 +/- 4.8) degree, respectively, indicating there were significant differences when compared with before operation (P < 0.05). According to Maryland foot score system, 15 cases were graded as excellent, 18 cases were good, 4 cases were poor, and the excellent and good rate was 89.19%.


CONCLUSIONS
Open reduction, bone grafting, and internal fixation with plastic ti-alloy plate is an effective method to treat intra-articular calcaneal fracture. Choosing right operational timing, performing subarticular surface grafting when necessary and using appropriate plastic ti-alloy plate internal fixation can minimize the incidence of postoperative complications.
Zhang
Qifeng
Q
Department of Orthopaedics, the Traditional Chinese Medicine Hospital of Tongzhou, Tongzhou Jiangsu, 226300, PR China. zhangqf126@126.com
D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D016025:Bone Transplantation; D002111:Calcaneus / Q000293:injuries*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult