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Abstract
Purpose
To evaluate the clinical efficacy of F-plate in displaced intra-articular fractures of calcaneus.
Materials and Methods
Total 43 cases treated with F-plate and followed up at least six months postoperatively were reviewed. Radiographically, Böhler angle was measured and all cases were subdivided by Sanders classification. Each case was reviewed for the presence of local infection, traumatic arthritis, nonunion, and any breakage of plate or screw. Maryland foot score was used for clinical assessment and factors influencing on clinical results were determined.
Results
The mean Böhler angle was improved from 0.5° (range: -24.7~35.5°) preoperatively to 25.8° (range: 14.2~38.6°) postoperatively and the angle at last follow-up was 23.5° (range: 10.2~37.5°), showing about 2.3 degree decline compared to postoperative Böhler angle. There were two cases of F-plate breakage and two cases of screw breakage but the metal breakage did not affect any change in Böhler angle. Other complications were; five cases of traumatic arthritis, one case of varus malunion and one case of deep wound infection. According to Maryland foot score, there were 10 excellent, 22 good, 10 fair and 1 poor result. Furthermore, Age, pre-operative Böhler angle and the patient's expectation on financial compensation had significant influences upon the clinical result.
Figures and Tables
Fig. 1
A 45-year-old male patient sustained intra-articular calcaneus fracture by fall down from 2 meter height.
(A) Intraoperative photograph shows extensile lateral approach.
(B) Preoperative X-ray shows joint depression type intra-articular calcaneal fracture with negative Böhler angle.
(C) Preoperative semicoronal CT scan shows Sanders IIA calcaneal fracture.
(D) Postoperative X-ray shows restoration of Böhler angle and stable fixation.
Fig. 2
Correlation of Böhler angle at initial and postoperative six months. The immediate postoperative Böhler angle was maintained to postoperative six months.
preop: Preoperative Böhler angle (broken line), patient: Each patient was ordered according to the degree of Böhler angle, difference: Between imediate postoperative state and postoperative six months in Böhler angle (solid line).
Fig. 3
A 40-year-old-male patient was treated using a F-plate. Postoperative 20 months X-ray shows breakage of plate but metal breakage did not affect any change in Böhler angle.
References
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