Sanders II-III calcaneal fractures fixed with locking plate in elderly patients

Abstract

Purpose: To evaluate the clinical outcomes of locking calcaneal plate in treating calcaneal fracture (Sanders II-III) in elderly patients.

Methods: From October 2012 to December 2013, 23 elderly patients suffering from calcaneal fracture (Sanders II-III) were treated and followed up. There were 15 males and 8 females with the mean age of 68.5 years (range: 65-79 years). According to Sander's classification, 16 cases (16 feet) were type II fractures and 7 cases (7 feet) were type III fractures. Anteroposterior, lateral and axial views of X-ray were taken to detect the calcaneum. CT scan was done to assess the amount of comminution and articular depression. Radiological assessment was performed using Bohler's angle and Gissane's angle. Functional outcome was assessed using the Maryland foot score.

Results: All the patients were followed up for 13.7 months on average (10-20 months). The mean time of bone union was 3.2 months (3-4 months). The mean time of complete weight bearing was 3.2 months (3.1-4.0 months). The soft tissue necrosis was found in 1 case. The mean Bohler's angle and Gissane's angle were 25.31° and 117.5°respectively. The overall excellent to good rate was 82.6%.

Conclusion: Open reduction and internal fixation with locking calcaneal plate can obtain good functional outcome for Sanders II-III calcaneal fractures in elderly patients.

Fig. 1

X-ray images of Sander III calcaneal fracture. A: Preoperative lateral view of X-ray in the calcaneus showed several fracture lines of calcaneus, affecting subtalar joint surface; B: Preoperative axial view of X-ray in the calcaneus showed comminuted fracture in a widened calcaneus; C: Postoperative lateral view of X-ray in the calcaneus showed that the height of calcaneus, Bohler's angel, Gissane's angle and subtalar joint surface were recovered; D: Postoperative axial view of X-ray in the calcaneus showed a recovered width and normal contour of the calcaneus.