Design and application of small butterfly-shaped plate for treatment of intra-articular calcaneal fractures

Objective To design small butterfly-shape plate, applyit to treat intra-articular calcaneal fractures and discuss its clinical indications, advantages and disadvantages. Methods Open reduction and internal fixation via small incision with small butterfly-shape plate were performed from February 2001 to April 2004 on 22 cases (26 sides) with intra-articular calcaneal fractures including 16 males (19 feet) and six females (seven feet), with average age of 36.8 years (23-61 years). There were 18 cases (18 feet) with unilateral fractures, four (eight feet) with bilateral fractures, 11 left feet fractures and 15 right feet fractures. The injury causes included fall from a height (20 cases, 24 feet) and traffic accidents (two cases, two feet). According to Sanders classification, there were 12 feet of type Ⅱ (three type Ⅱa, seven type Ⅱb and two type Ⅱc) and 14 feet of type Ⅲ (five Ⅲab, seven Ⅲac and two Ⅲbc). Results Seventeen cases (21 feet) were followed up for average 19.2 months (12-34 months). Maryland foot score system showed that nine feet with type Ⅱ fractures obtained excellent results in seven and good in two and that 12 feet of type Ⅲ fractures won excellent results in six, good in five and fair in one. All cases with foot shape restored to normal could wear regular shoes, without lame. Plain radiographs showed basic restoration of Bhler's angle, Gissane's angle, talus inclining angle, calcaneal width and height of the thalamus, with insignificant complications. Conclusion The small butterfly-shape plate is suitable for surgical treatment of Sanders Ⅱ and Ⅲ type calcaneal fractures, with advantages of reliable fixation, simple operation, few complications and good clinical results.