[Case control study on anatomical locking plate and ordinary steel plate for the treatment of closed calcaneal fracture with SandersⅡand Ⅲ].

Objective: To compare clinical efficacy between anatomical locking plate (ALP) and ordinary steel plate (OSP) in treating closed calcaneal fractures with SandersⅡ and Ⅲ.

Methods: From May 2016 to May 2018, 68 patients with closed Sanders typeⅡ and Ⅲ calcaneal fractures were retrospectively analyzed, and were divided into anatomical locking plate group (ALP group) and ordinary steel plate group (OSP group) according to two kinds of plate fixation, and 34 patients in each group. In ALP group, there were 21 males and 13 females aged from 20 to 63 years old with average of (35.16±8.45) years old; 14 patients were typeⅡand 20 patients were type Ⅲaccording to Sanders classification;treated with ALP. In OSP group, there were 20 males and 14 females aged from 19 to 63 years old with average of (35.05±8.39) years old;19 patients were typeⅡand 15 patients were type Ⅲ according to Sanders classification;treated with OSP. Operative time, intraoperative blood loss and complications between two groups were observed and compared;preoperative and postoperative Böhler angle and gissane angle were also compared;American Orthopaedic Foot & Ankle Society (AOFAS) ankle and hind foot scores, foot and ankle disability index (FADI) scores were applied to evaluate clinical effect.

Results: All patients were followed up from 11 to 14 months with an average of (12.06±0.81) months. There were no statistical differences in opertive time, intraoperative blood loss, incision infection and refracture rate in complications between two groups (>0.05);while there was significant difference in the number of screw loosening (<0.05). Böhler angle and Gissane angle in ALP group at 6 and 12 months after opertaion were higher than that of OSP group (<0.05), and the degree of improvement of Böhler angle and Gissane angle in ALP group were also higher than that of OSP group (<0.05). Postopertaive AOFAS score and FADI score at 6 and 12 months in ALP group were higher than that of OSP group (<0.05), while no statistical difference in AOFAS grading between two groups(>0.05).

Conclusion: Compared with OSP, ALP in treating SandersⅡ and Ⅲ calcaneal fractures could achieve better therapeutic effect, avoid screw loosening, reduce complications, and improve limb function in further.