Introduction The results of open reduction and internal fixation of displaced intra-articular calcaneal fractures has been shown to be superior to closed management. We report our early experience with the AO locking calcaneal plate for these injuries in particular looking for wound complications.

Methods Between December 2001 and March 2003 a total of 28 patients with 29 displaced intra-articular calcaneal fractures were treated by two surgeons. The average delay from injury to time of surgery was 11 days. A standard “L” shape lateral approach was used with the patient in a lateral decubitus position. Reduction was temporarily held with K wires before the locking plate was applied, with the bending tools used for in-situ plate moulding. Wounds were closed over a drain using Allgower-Donati sutures after haemostasis. Stitches were removed at two weeks when the wounds had healed.

Results Of the 29 fractures treated there was only two minor wound problems. In one patient this occurred after using the larger plate and consisted of slight necrosis at the inferior corner of the wound, which healed non-operatively. There have been two patients requiring removal of their plates between 10 and 15 months after surgery. They both complained of lateral pain, which may have been due to the plate being bulkier than other currently used plates. After removal both patients had immediate relief from their symptoms. The AO locking plate offers advantages over the standard plate. These include the option for locking screws as well as 2.7 mm and 3.5 mm screws, increased strength, and the ability to mould the plate in-situ using the bending irons in the screw holes. This in-situ moulding allows better contouring of the plate. On one occasion even this plate was too large and required trimming to fit the bone. We have not experienced an increase in wound problems due to bulkier plate.

Conclusions Our early experience with the AO Locking plate has been positive, with minimal complications. We would recommend the use of this plate for fixation of displaced intra-articular calcaneal fractures, and suggest the need for a smaller plate to be designed.