Minimally invasive percutaneous plate fixation in the treatment of calcaneal fractures

CHEN Yong-gang; XIAO Xun-gang; WEI Xiao-dong; ZHOU Tao

doi:10.3969/j.issn.2095-252X.2017.11.008

Abstract：Objective To evaluate clinical effects of minimally invasive percutaneous plate osteosynthesis ( MIPPO ) in the treatment of calcaneal fractures. Methods From January 2010 to September 2015, 31 cases ( 35 feet, intra-articular calcaneal fractures ) treated with MIPPO were retrospectively analyzed. Fracture classification: Sanders II ( 16 cases ), Sanders III ( 15 cases ). Surgical incision: calcaneal tarsal sinus incision with a small straight edge incision of the Achilles tendon. Fracture was fixed by calcaneal lateral dissection plate. The results were evaluated by Maryland foot scoring system and radiographic examination. Results All patients were followed up for 12 - 24 months ( average:15.2 months ). All fractures healed. No delayed union or nonunion occurred. There were no complications such as wound infection and incision nonunion. Complete load-bearing time ranged 3 - 4 months ( average: 3.5 months ). The average Bohler angle was ( 8.2 ± 5.5 ) ° preoperatively and ( 28.5 ± 4.3 ) ° postoperatively with statistical difference ( P < 0.05 ). The Gissane angle of the calcaneus recovered from ( 96.5 ± 9.5 ) ° preoperatively to ( 120.4 ± 6.3 ) ° at the final follow-up, and the differences were statistically significant ( P < 0.05 ). All patients had no significant loss of calcaneus Bohler angle or Gissane angle compared with those at the final follow-up. Maryland Foot score:excellent 18 feet, good 13 feet, fair 4 feet, excellent and good rate 88.5%. Sanders II: excellent 10 feet, good 6 feet, fair 1 foot, excellent and good rate 94.1%. Sanders III: excellent 9 feet, good 7 feet, fair 2 feet, excellent and good rate 88.9%. Conclusions MIPPO can achieve good clinical results in the treatment of Sanders II and III fractures, while Sanders II results are more satisfactory than Sanders III.