Comparing small locking plate fixation versus small locking plate with screws fixation of displaced intra-articular calcaneus fracture via sinus tarsi approach

Abstract

Abstract Background The purpose of this study was to compare the clinical and radiological outcomes of displaced intra-articular calcaneus fractures (DIACFs) treated with small locking plates alone versus small locking plates combined with screws. Methods Retrospective analysis of 120 patients with intra-articular fractures seen from May 2018 to June 2020, all of whom were surgically repositioned using sinus tarsal approach.60 cases received a small locking plate combined with screws fixation (observation group) and 60 cases received a small locking plate fixation alone (control group).Demographic variables were recorded and compared Gissane angle, Bohler's angle, calcaneal varus, and joint line parallel angle at 3 days and 2 years postoperative follow-up.The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot Score and VAS were applied to assess postoperative foot function, and complications were also compared. Results Compared with the control group, the joint line parallel angle and calcaneal varus in the observation group had lower displacement changes from the postoperative period to the 2-year follow-up,they are 0.07 (0.15) degrees vs 0.47 (0.59) degrees(P < 0.001), 0.19 (0.35) degrees vs 1.18 (0.67) degrees(P < 0.001).There was no significant difference in Gissane angle and Bohler's angle between the observation group and the control group at the preoperative, 3-year and 2-year follow-up (P > 0.05).The final AOFAS score, VAS score and complications were not significantly different between the two groups (P > 0.05). Conclusion When STA is used to treat DIACFs, fixation with a small locking plate combined with screws appears to provide better posterior articular surface stability and better maintenance of calcaneal axial stability than fixation with a small locking plate alone,the two techniques had similar functional outcomes and complications after surgery.