Locking plate can prevent the loss of reduction for intra-articular calcaneal fractures

doi:10.3969/j.issn.2095-4344.2017.15.016

Abstract

Abstract:

BACKGROUND: Comminuted intra-articular fractures of the calcaneus are difficult to treat, and inappropriate treatment will lead to some sequelae such as talalgia, traumatic arthritis and flatfoot, which do harm to functional recovery.

OBJECTIVE: To compare the clinical efficacy of locking and traditional plates for intra-articular calcaneal fractures

METHODS: Seventy-six patients (94 feet) with intra-articular calcaneal fractures were enrolled, and received open reduction and plate internal fixation. All patients were allotted to two groups based on the fixation materials, including locking plate and traditional plate groups. The healing time, AOFAS scores, Visual Analogue Scale scores, loss of Bohler angle and adverse events were compared between groups. In addition, the loss of Bohler angle of osteoporotic patients was compared between groups.

RESULTS AND CONCLUSION: There were no significant differences in the healing time, AOFAS scores, Visual Analogue Scale scores and Bohler angle between two groups after surgery (P > 0.05). But for osteoporotic patients, compared with the traditional plate group, the loss of Bohler angle was smaller in the locking plate group. These results suggest that the various clinical and radiographic indicators of locking plate and traditional plate for intra-articular calcaneal fractures show no significant differences. For osteoporotic patients, locking plate has certain advantages in preventing loss of joint reduction, but large-size trials are needed.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Calcaneus, Fractures, Bone, Internal Fixators, Osteoporosis

CLC Number:

R318

Liu Wen-hu. Locking plate can prevent the loss of reduction for intra-articular calcaneal fractures[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(15): 2383-2387.

Figures/Tables 1

References

[1] Brauer CA, Manns BJ，Ko M，et al.An economic evaluation of operative Compared with nonoperative management of displaced intra-articular calcaneal fractures.J Bone Joint Surg(Am).2005;87:2741-2749.

[2] 陈欣,姜宏. 跟骨复位器配合克氏针撬拨治疗SandersⅡ型跟骨骨折46例[J].实用骨科杂志, 2014,20(7):657-659.

[3] Griffin D, Parsons N, Shaw E, et al. Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial.Nederlands Tijdschrift voor Traumachirurgie.2015; 349(1):g4483.

[4] 张铁良,于建华.跟骨关节内骨折[J].中华骨科杂志,2000,20(2): 117-120.

[5] 张英泽,宋朝晖,韩久卉,等.智能机器人辅助治疗复杂性跟骨骨折[J].河北医科大学学报,2005,26(2):134-135.

[6] Holm JL, Laxson SE, Schuberth JM.Primary Subtalar Joint Arthrodesis for Comminuted Fractures of the Calcaneus. J Foot Ankle Surg.2015;54(1):61-65.

[7] 樊金辉,马虎升,靳国强,等.推进缝合在预防跟骨骨折术后切口并发症中的应用效果[J]. 中国当代医药,2015, 29(9):839-860.

[8] 严广斌. AOFAS踝-后足评分系统[J]. 中华关节外科杂志电子版, 2014,8(4):557-557.

[9] Redfern DJ, Oliveira ML, Campbell JT,et al.A biomechanical comparision of locking and nonlocking plates for the fixation of calcaneal factures.Foot Ankle Int.2006;27(3):196-201.

[10] Stoffel K,Booth G, Rohrl SM,et al.A comparison of conventional versus locking plates in intra-articular calcaneus fractures:A biomechanical study in human cadavers. Clin Biomechanics.2007;22:100-105.

[11] 王云根,张伟中,徐浩,等. 动力髁螺钉、锁定钢板和AO解剖钢板治疗股骨远端骨折的临床疗效比较[J].广东医学, 2011, 32(16): 2141-2143.

[12] 覃勇志, 冉学军, 蒲川成,等. 解剖锁定钢板植骨与不植骨治疗Sanders Ⅲ、Ⅳ型跟骨骨折疗效比较[J]. 临床骨科杂志, 2014, 17(1):88-90.

[13] 高峰,李翔,方永祥,等. 普通解剖钢板加植骨与锁定钢板治疗Sanders Ⅱ、Ⅲ型跟骨骨折的疗效比较[J]. 中华创伤骨科杂志, 2015, 17(9):791-795.

[14] 张国柱,蒋协远,王满宜. 外置解剖型跟骨锁定钢板治疗跟骨骨折的初步报告[J]. 中华创伤骨科杂志, 2010,12(8):741-745.

[15] 张留栓.小切口微型锁定钢板治疗SandersⅡ型及部分Ⅲ型跟骨骨折效果分析[J]. 现代中西医结合杂志, 2016, 25(10):1102- 1105.

[16] 徐小峰,魏长宝,黄永辉,等. 闭合复位锁定钢板外置和切开复位锁定钢板内置治疗SandersⅡ、Ⅲ型跟骨骨折的临床对照研究[J]. 江苏大学学报:医学版,2016, 26(3),12.

[17] 魏文鹏,杨志. 跟骨锁定钢板内固定术治疗跟骨骨折[J].山东医药,2011, 51(42):95-96.

[18] Cao L, Weng W, Song S, et al.Surgical treatment of calcaneal fractures of Sanders type II and III by a minimally invasive technique using a locking plate. J Foot Ankle Surg. 2015; 54(1):76-81

[19] Chen K, Zhang H, Wang G, et al. Comparison of nonlocking plates and locking plates for intraarticular calcaneal fracture. Foot Ankle Int. 2014 ;35(12):1298-1302.

[20] Sanders R,Vaupel ZM,Erdogan M,et al.Operative treatment of displaced intraarticular calcaneal fractures: long-term (10-20 Years) results in 108 fractures using a prognostic CT classification.2014；28(10):551-563.

[21] Backes M, Schepers T, Beerekamp MS, et al. Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach. Int Orthop. 2014;38(4):767-773.

[22] Abdelazeem A,Khedr A,Abousayed M,et al.Management of displaced intra-articular calcaneal fractures using the limited open sinus tarsi approach and fixation by screws only technique. Int Orthop. 2014;38(3):601-606.

[23] 王金辉,武勇,杨明辉,等. 钢板内固定--跟骨关节内骨折治疗的最好方法[J]. 中华创伤骨科杂志,2006, 8(5):407-410.

[24] 厉国定,张俊,沈燕国,等. 切开复位钢板内固定治疗跟骨关节内骨折[J].实用骨科杂志, 2011,17(7):656-658.

[25] 俞光荣,燕晓宇.新鲜跟骨骨折的治疗[J].中华创伤骨科杂志, 2007,9(12):1173-1178.

[26] Zhang T, Su Y, Chen W, et al. Displaced intra-articular calcaneal fractures treated in a minimally invasive fashion: longitudinal approach versus sinus tarsi approach. J Bone Joint Surg Am. 2014;96(4):302-309.

[27] Veltman ES, van den Bekerom MP, Doornberg JN, et al. Three-dimensional computed tomography is not indicated for the classification and characterization of calcaneal fractures. Injury. 2014;45(7):1117-1120

[28] Zhang W, Chen E, Xue D, et al. Risk factors for wound complications of closed calcaneal fractures after surgery: a systematic review and meta-analysis. Scand J Trauma Resusc Emerg Med. 2015;23:18.

[29] Yu X, Pang Q J, Chen L, et al. Postoperative complications after closed calcaneus fracture treated by open reduction and internal fixation: a review. J Int Med Res. 2014;42(1):17-25.