Abstract
There are many reports of treatment for intraarticular fractures of the calcaneus using different methods. Results are very difficult to compare. For this reason a prospective study was designed to compare the outcome of the same type of fracture treated with Stein-mann pinning or plate osteosynthesis.
Between January 1995 and March 1999 31 patients with two-part intraarticular fractures of the calcaneus, type IIB according to the Sanders classification, were treated operatively with either transcalcaneal pinning (12 fractures) or with open reduction and internal plate and screw fixation using a lateral approach (19 fractures). After a mean follow-up of 26 months all patients were assessed. A comparison was made between the two modes of treatment. The global score averaged 78.3 ± 12.1; 79.3 ± 11.14 for the patients treated with plate and screw fixation, and 76.6 ± 13.2 for the patients who underwent pinning. Lateral X-rays showed no difference in anatomical reduction between both methods. A positive correlation was demonstrated between the AOFAS Ankle-Hindfoot score and Böhler’s angle. The restoration of the congruity of the posterior subtalar joint was assessed postoperatively by means of a CT scan. The angle between the undersurface of the talus and the lateral fragment of the two-part fracture was evaluated. No statistically significant difference was found between both groups.
The authors conclude that there is no difference in functional outcome between both modes of treatment. Plate osteosynthesis has the advantage that the shape of the hindfoot and midfoot is restored, but the higher complication rate is a drawback.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
