PRELIMINARY EFFECTIVENESS OF I.T.S. LOCKING PLATE FOR INTRA-ARTICULAR CALCANEAL FRACTURES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WU Junguo ¹ , CHAI Yimin ² , DONG Youhai ¹ , GU Wenqi ² , HUANG Hanwei ¹ , JIANG Haiying ¹ , CHEN Jian ¹ , CHEN Xujun ¹ , QIAN Guang ¹ , HUANG Peiyan ¹

1Department of Orthopaedics, the Fifth People’s Hospital of Shanghai, Fudan University, Shanghai, 200240, P.R.China;;
2Department of Orthopaedics, Shanghai Sixth People’s Hospital, Shanghai Jiaotong University. Corresponding author: DONG Youhai, E-mail: brianiano8@163.com;

Corresponding author：

Keywords：

Intra-articular calcaneal fracture; I.T.S. locking plate; Open reduction; Internal fixation

DOI：

10.7507/1002-1892.20130231

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Objective To summarize the preliminary effectiveness of I.T.S. locking plate for intra-articular calcaneal fractures. Methods Between July 2010 and July 2011, 18 cases of intra-articular calcaneal fractures were treated. There were 10 males and 8 females with an average age of 46 years (range, 25-64 years). According to Sanders classification system, there were 3 cases of type II, 9 cases of type III, and 6 cases of type IV. The disease duration was 5-11 days (mean, 6 days). Open reduction and internal fixation with I.T.S. locking plate were performed via an L-shaped lateral extending incision. Results Superficial infection occurred in 1 case, and was cured after dressing changing; healing of incision by first intention was obtained in the other cases. Sixteen cases were followed up 14 months on average (range, 12-18 months). X-ray films demonstrated the bone union in all cases with an average union time of 12 weeks (range, 10-14 weeks). No implant failure or irritation of peroneal tendon occurred during follow-up. X-ray films showed subtalar post-traumatic arthritis with mild pain in 1 case at 11 months after operation, which was relieved by conservative treatment. At last follow-up, the B ouml;hler angle was improved from (12.9 ± 3.2)° preoperatively to (33.8 ± 4.0)° postoperatively, showing significant difference (t=22.78, P=0.00); the Gissane angle was improved from (83.6 ± 6.4)° preoperatively to (119.9 ± 8.5)° postoperatively, showing significant difference (t=17.02, P=0.00). The visual analogue scale (VAS) score was 1.3 ± 1.2, and the ankle and hindfoot scale of American Orthopaedic Foot and Ankle Society (AOFAS) was 80.3 ± 7.9 at last follow-up. Conclusion Treatment of intra-articular calcaneal fracture with I.T.S. locking plate can obtain a stable fixation, which is a safe and effective method.

Citation： WU Junguo,CHAI Yimin,DONG Youhai,GU Wenqi,HUANG Hanwei,JIANG Haiying,CHEN Jian,CHEN Xujun,QIAN Guang,HUANG Peiyan. PRELIMINARY EFFECTIVENESS OF I.T.S. LOCKING PLATE FOR INTRA-ARTICULAR CALCANEAL FRACTURES. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(9): 1057-1060. doi: 10.7507/1002-1892.20130231 Copy

1.	Sanders R, Fortin P, DiPasquale T, et al. Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification. Clin Orthop Relat Res, 1993, (290): 87-95.
2.	蒋协远, 王大伟. 骨科临床疗效评价标准. 北京: 人民卫生出版社, 2005: 231-233.
3.	Schon LC, Wisbeck JM. Minimally invasive plate fixation of calcaneus fractures. Tech Orthop, 2012, 27(2): 118-125.
4.	Goldzak M, Mittlmeier T, Simon P. Locked nailing for the treatment of displaced articular fractures of the calcaneus: description of a new procedure with calcanail(®). Eur J Orthop Surg Traumatol, 2012, 22(4): 345-349.
5.	Hyer CF, Atway S, Berlet GC, et al. Early weight bearing of calcaneal fractures fixated with locked plates: a radiographic review. Foot Ankle Spec, 2010, 3(6): 320-323.
6.	Richter M, Gosling T, Zech S, et al. A comparison of plates with and without locking screws in a calcaneal fracture model. Foot Ankle Int, 2005, 26(4): 309-319.
7.	Illert T, Rammelt S, Drewes T, et al. Stability of locking and non-locking plates in an osteoporotic calcaneal fracture model. Foot Ankle Int, 2011, 32(3): 307-313.
8.	Stoffel K, Booth G, Rohrl SM, et al. A comparison of conventional versus locking plates in intraarticular calcaneus fractures: a biomechanical study in human cadavers. Clin Biomech (Bristol, Avon), 2007, 22(1): 100-105.
9.	ten Broeke RH, Alves A, Baumann A, et al. Bone reaction to a biomimetic third-generation hydroxyapatite coating and new surface treatment for the Symax hip stem. J Bone Joint Surg (Br), 2011, 93(6): 760-768.
10.	SooHoo NF, Farng E, Krenek L, et al. Complication rates following operative treatment of calcaneus fractures. Foot Ankle Surg, 2011, 17(4): 233-238.
11.	Buckley R, Tough S, McCormack R, et al. Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial. J Bone Joint Surg (Am), 2002, 84-A(10): 1733-1744.
12.	Schepers T. The sinus tarsi approach in displaced intra-articular calcaneal fractures: a systematic review. Int Orthop, 2011, 35(5): 697-703.
13.	Woon CY, Chong KW, Yeo W, et al. Subtalar arthroscopy and flurosocopy in percutaneous fixation of intra-articular calcaneal fractures: the best of both worlds. J Trauma, 2011, 71(4): 917-925.
14.	Kissel CG, Husain ZS, Cottom JM, et al. Early clinical and radiographic outcomes after treatment of displaced intra-articular calcaneal fractures using delta-frame external fixator construct. J Foot Ankle Surg, 2011, 50(2): 135-140.
15.	施忠民, 顾文奇, 蒋垚. 微创锁定板内固定治疗跟骨关节内骨折. 中华创伤骨科杂志, 2012, 14(8): 648-653.
16.	Femino JE, Vaseenon T, Levin DA, et al. Modification of the sinus tarsi approach for open reduction and plate fixation of intra-articular calcaneus fractures: the limits of proximal extension based upon the vascular anatomy of the lateral calcaneal artery. Iowa Orthop J, 2010, 30: 161-167.

1. Sanders R, Fortin P, DiPasquale T, et al. Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification. Clin Orthop Relat Res, 1993, (290): 87-95.
2. 蒋协远, 王大伟. 骨科临床疗效评价标准. 北京: 人民卫生出版社, 2005: 231-233.
3. Schon LC, Wisbeck JM. Minimally invasive plate fixation of calcaneus fractures. Tech Orthop, 2012, 27(2): 118-125.
4. Goldzak M, Mittlmeier T, Simon P. Locked nailing for the treatment of displaced articular fractures of the calcaneus: description of a new procedure with calcanail(®). Eur J Orthop Surg Traumatol, 2012, 22(4): 345-349.
5. Hyer CF, Atway S, Berlet GC, et al. Early weight bearing of calcaneal fractures fixated with locked plates: a radiographic review. Foot Ankle Spec, 2010, 3(6): 320-323.
6. Richter M, Gosling T, Zech S, et al. A comparison of plates with and without locking screws in a calcaneal fracture model. Foot Ankle Int, 2005, 26(4): 309-319.
7. Illert T, Rammelt S, Drewes T, et al. Stability of locking and non-locking plates in an osteoporotic calcaneal fracture model. Foot Ankle Int, 2011, 32(3): 307-313.
8. Stoffel K, Booth G, Rohrl SM, et al. A comparison of conventional versus locking plates in intraarticular calcaneus fractures: a biomechanical study in human cadavers. Clin Biomech (Bristol, Avon), 2007, 22(1): 100-105.
9. ten Broeke RH, Alves A, Baumann A, et al. Bone reaction to a biomimetic third-generation hydroxyapatite coating and new surface treatment for the Symax hip stem. J Bone Joint Surg (Br), 2011, 93(6): 760-768.
10. SooHoo NF, Farng E, Krenek L, et al. Complication rates following operative treatment of calcaneus fractures. Foot Ankle Surg, 2011, 17(4): 233-238.
11. Buckley R, Tough S, McCormack R, et al. Operative compared with nonoperative treatment of displaced intra-articular calcaneal fractures: a prospective, randomized, controlled multicenter trial. J Bone Joint Surg (Am), 2002, 84-A(10): 1733-1744.
12. Schepers T. The sinus tarsi approach in displaced intra-articular calcaneal fractures: a systematic review. Int Orthop, 2011, 35(5): 697-703.
13. Woon CY, Chong KW, Yeo W, et al. Subtalar arthroscopy and flurosocopy in percutaneous fixation of intra-articular calcaneal fractures: the best of both worlds. J Trauma, 2011, 71(4): 917-925.
14. Kissel CG, Husain ZS, Cottom JM, et al. Early clinical and radiographic outcomes after treatment of displaced intra-articular calcaneal fractures using delta-frame external fixator construct. J Foot Ankle Surg, 2011, 50(2): 135-140.
15. 施忠民, 顾文奇, 蒋垚. 微创锁定板内固定治疗跟骨关节内骨折. 中华创伤骨科杂志, 2012, 14(8): 648-653.
16. Femino JE, Vaseenon T, Levin DA, et al. Modification of the sinus tarsi approach for open reduction and plate fixation of intra-articular calcaneus fractures: the limits of proximal extension based upon the vascular anatomy of the lateral calcaneal artery. Iowa Orthop J, 2010, 30: 161-167.

Chinese Journal of Reparative and Reconstructive Surgery

PRELIMINARY EFFECTIVENESS OF I.T.S. LOCKING PLATE FOR INTRA-ARTICULAR CALCANEAL FRACTURES

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