title: [Treatment of intra-articular calcaneal fractures with unilateral external fixator combined with limited internal fixation].
abstract: OBJECTIVE
  To study the clinical effects of the unilateral external fixator combined with limited internal fixation such as cannulated lag screws for the treatment of intra-articular calcaneal fractures.
  
  
  METHODS
  From May 2007 to February 2012,52 patients (58 feet) with intraarticular calcaneal fractures were treated with unilateral external fixator and limited internal fixation such as lag screws. Forty-five patients (51 feet) were male,7 patients (7 feet) were female,ranging in age from 18 to 64 years,averaged 36.5 years. Time from injury to surgery was 4 to 13 (6.2 +/- 0.8) days. According to Sanders classification, there were 36 cases (40 feet) with type II fractures, 13 cases (15 feet) with type III fractures, 3 cases (3 feet) with type IV fractures. All patients were examed with X-ray and CT. Böhler angle, Gissane angle, length, width, height were measured on the radiographs, respectively. The function of the feet was assessed by the Maryland grading system.
  
  
  RESULTS
  Fifty-one patients(57 feet) were followed up for 5 to 16 months,with an average of 7.2 months. Calcaneal Böhler angle increased from (12.65 +/- 5.32) degrees preoperatively to (30.63 +/- 4.28) degrees postoperatively. The calcaneal Gissane angle decreased from (129.87 +/- 6.25) degrees preoperatively to (122.11 +/- 4.89) degrees postoperatively. The calcaneal length increased from (64.5 +/- 7.1) mm preoperatively to (71.3 +/- 5.7) mm postoperatively. The calcaneal width decreased from (34.6 +/- 5.7) mm preoperatively to (28.2 +/- 6.1) mm postoperatively. The calcaneal height increased from (30.2 +/- 5.2) mm preoperatively to (39.3 +/- 6.4) mm postoperatively. All of the comparison between preoperative and postoperative measurements revealed statistically significant (P < 0.05). The length,width, height, Böhler angle and Gissane angle were improved significantly (P < 0.05). According to the Maryland grading system, the result was excellent in 20 feet, good in 31 feet, fair in 4 feet, pour in 2 feet,excellent and good rate was 89.5%. Three feet with wound infection or flap necrosis were healed after wound debridement and dressing exchange.
  
  
  CONCLUSIONS
  The unilateral external fixation combined with limited internal fixation is a satisfactory treatment for intra-articular calcaneal fractures in short term with less damage, few complications and good functional recovery.
authors.affiliation: Department of Orthopaedics, Southern Branch of the Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 201499, China. xuemd@yahoo.com.cn
authors.forename: Feng
authors.initials: F
authors.lastname: Xue
authors.affiliation: Department of Orthopaedics, Southern Branch of the Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 201499, China.
authors.forename: Lei-Zi
authors.initials: LZ
authors.lastname: Chai
authors.affiliation: Department of Orthopaedics, Southern Branch of the Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 201499, China.
authors.forename: Hai-Jun
authors.initials: HJ
authors.lastname: Xiao
authors.affiliation: Department of Orthopaedics, Southern Branch of the Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 201499, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Ding
authors.affiliation: Department of Orthopaedics, Southern Branch of the Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 201499, China.
authors.forename: Yu-Chun
authors.initials: YC
authors.lastname: Shen
authors.affiliation: Department of Orthopaedics, Southern Branch of the Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 201499, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D002111:Calcaneus / Q000293:injuries / Q000601:surgery*; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D005593:Fracture Fixation, Internal; D006801:Humans; D057072:Intra-Articular Fractures / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult