Comparison of screw versus locking plate fixation via sinus tarsi approach for displaced intra-articular calcaneal fractures

Kohei Sato; Masanori Yorimitsu; Takenori Uehara; Shiro Fukuoka; Toshiaki Hata; Kenta Saiga; Tomoyuki Noda; Toshifumi Ozaki

doi:10.1016/j.fas.2022.11.002

Comparison of screw versus locking plate fixation via sinus tarsi approach for displaced intra-articular calcaneal fractures

Foot Ankle Surg. 2023 Jan;29(1):97-102. doi: 10.1016/j.fas.2022.11.002. Epub 2022 Nov 21.

Authors

Kohei Sato¹, Masanori Yorimitsu², Takenori Uehara³, Shiro Fukuoka¹, Toshiaki Hata¹, Kenta Saiga⁴, Tomoyuki Noda⁵, Toshifumi Ozaki¹

Affiliations

¹ Department of Orthopedic Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata, Kitaku, Okayama City, Okayama, Japan.
² Department of Musculoskeletal Traumatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata, Kitaku, Okayama City, Okayama, Japan. Electronic address: [email protected].
³ Department of Emergency Health Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata, Kitaku, Okayama City, Okayama, Japan.
⁴ Department of Musculoskeletal and Sports Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata, Kitaku, Okayama City, Okayama, Japan.
⁵ Department of Orthopedic Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kitaku, Okayama City, Okayama, Japan.

PMID: 36473825
DOI: 10.1016/j.fas.2022.11.002

Abstract

Background: The optimal treatment of displaced intra-articular calcaneal fractures (DIACF) is controversial. This study compared the fixation stability of screws and locking plates in DIACF treated via the sinus tarsi approach (STA).

Methods: We retrospectively evaluated 118 DIACF cases treated via STA and extracted data that could affect treatment outcomes. Loss of Böhler's angle after surgery was measured to compare fixation stability.

Results: The loss of Böhler's angles was significantly smaller in the locking plate group than in the screw group (2.6 ± 2.7º vs. 5.6 ± 5.3º, P < 0.01). There was no difference in the clinical outcomes between the groups. On multivariate logistic regression analysis, screw fixation was significantly associated with loss of Böhler's angle by> 10º (odds ratio, 8.63; 95% confidence interval, 1.16-64.4; P < 0.05).

Conclusions: Locking plate fixation is more reliable than screw fixation for preventing correction loss in DIACF treated via STA.

Level of evidence: III.

Keywords: Böhler’s angle; Calcaneal fracture; Locking plate fixation; Screw fixation; Sinus tarsi approach.

MeSH terms

Ankle Injuries*
Bone Plates
Bone Screws
Calcaneus* / surgery
Follow-Up Studies
Fracture Fixation, Internal
Fractures, Bone* / diagnostic imaging
Fractures, Bone* / surgery
Heel
Humans
Intra-Articular Fractures* / diagnostic imaging
Intra-Articular Fractures* / surgery
Retrospective Studies
Treatment Outcome