Early weight bearing of calcaneal fractures fixated with locked plates: a radiographic review

Abstract

The use of locked plate technology in the calcaneus has been shown in previous studies to provide greater stability than that of nonlocking plates. The purpose of this study is to examine the radiographic effects of early weight bearing of calcaneal fractures repaired with locked plating. A retrospective review was performed of 17 calcaneal fractures repaired with locked plate fixation over a 2-year period. A chart and radiographic review evaluated the time the patient was kept non-weight bearing and the Bohler's angle at first postoperative visit and final postoperative visit. Change in Bohler's angle was used to evaluate for bone subsidence. Standard reduction and fixation techniques were performed to realign all components of the intra-articular calcaneal fracture using a titanium locking calcaneal fracture plate. Patients returned for follow-up examinations postoperatively and underwent radiographic examination. A weight-bearing short fracture walker boot was applied, and the patient began protected weight bearing at approximately 4 to 5 weeks. The charts and radiographs of 17 intra-articular fractures were reviewed. The average Bohler's angle at first postoperative visit was 30.12° in comparison to the average at final visit of 28.47 °. The average time the patient was kept non-weight bearing after the procedure was 4.8 weeks. The average time of follow-up was 237.7 days. There were no cases of significant bone subsidence or collapse noted. Calcaneal fractures can have significant morbidity associated with the injury and its care. This study examined early weight bearing of calcaneal fractures fixated with locked plating. Under radiographic review, there was no significant loss of calcaneal height, joint reduction, or fixation stability noted. These results are thought to be due to the inherent stability of the locked plate construct.