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Abstract
Purpose
To evaluate the surgical outcomes of open reduction and internal fixation of AO calcaneal plate in displaced intra-articular fractures of the calcaneus.
Materials and Methods
From January 2004 to July 2007, 25 patients with 27 displaced intra-articular calcaneal fractures were treated by open reduction and internal fixation using the AO calcaneal plate. Preoperative, postoperative evaluations and a follow-up after 1 year were done radiologically by the Böhler angle, Gissane angle, heel height and width among all patients. Their functional status was assessed by means of the Maryland foot score.
Results
The mean Böhler angle, Gissane angle, heel height and width were restored comparing with preoperative data. However, in Sanders type IV, some losses of reduction occurred at 1 year follow-up (p<0.05). The mean Maryland foot scores were 85 points in type II, 82 points in type III and 63 points in type IV. Sanders types significantly affected the clinical results (p<0.05).
Figures and Tables
Figure 1
A 21-year-old female patient sustained left intra-articular calcaneal fracture by slip down.
(A) Preoperative X-ray shows tongue type intra-articular calcaneal fracture.
(B) Preoperative axial and sagittal CT scans show Sanders type IIb calcaneal fracture.
(C) Postoperative X-ray shows restoration of Böhler angle and heel width.
(D) At follow-up of 13months, X-ray shows no subtalar joint arthritis.
Figure 2
A 45-year-old male patient sustained right open comminuted intra-articular calcaneus fracture by fall down from 6 meter height.
(A) Preoperative X-ray shows joint depression type intra-articular calcaneal fracture with negative Böhler angle.
(B) Preoperative semicoronal and 3D CT scan shows Sanders type IV calcaneal fracture.
(C) Postoperative X-ray shows restoration of Böhler angle and stable fixation.
(D) Postoperative X-ray shows varus change of heel and malunion of calcaneus and losses of corrections.
Table 2
The relationship between Sanders type and Maryland foot score (Linear by linear association)
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