The effect of early weight-bearing on comminuted calcaneal fractures treated with locking plates

Abstract

Objectives: This study aims to evaluate the possible effects of early weight-bearing on clinical and radiological outcomes of comminuted calcaneal fractures treated with locking plates.
Patients and methods: This retrospective study included 15 patients (12 males, 3 females; mean age 40.1 years; range 18 to 55 years) with comminuted calcaneal fractures between October 2010 and April 2012. Standard lateral extensile approach was carried out for surgical exposure. A corticocancellous allograft was used to fill the defect following the reduction and fixation of posterior facet. Titanium locking plates and screws were used to maintain reduction. The patients were encouraged for a limited weight-bearing at six weeks postoperatively, if tolerated. All patients were able to full weight-bear at 12 weeks postoperatively. Clinical and radiological assessments were performed using the American Orthopaedic Foot and Ankle Society (AOFAS) and Maryland scores.
Results: The mean follow-up was 19 months (range, 12 to 27 months). The AOFAS and Maryland scores were 89 and 88.46 points, respectively. The Böhler’s angle showed 0.3° loss from early post-surgery to the last visit. Among the workers, all returned to work but one with Sanders type IV fracture and all retired patients returned to their daily activities. The functional status of the patient with Sanders type IV fracture was poor according to the AOFAS and Maryland criteria.
Conclusion: Based on radiographic and clinical assessment, there was no unfavorable effect of early weight-bearing after calcaneal fracture surgery. Therefore, these results suggest that sufficient stability can be achieved by locking plates in comminuted calcaneal fractures, when early weight-bearing is recommended, even.