Comparison of Nonlocking Plates and Locking Plates for Intraarticular Calcaneal Fracture

Background: The optimal treatment of displaced intraarticular calcaneal fractures remains challenging. Currently, there is no uniform method to treat such fractures. The purpose of this study was to compare the radiographic and clinical outcome of nonlocking plates and locking plates in the treatment of intraarticular calcaneal fractures. Methods: A retrospective comparative study was performed including 42 patients with intraarticular calcaneal fractures that were treated by nonlocking plate (n = 18) or locking plates (n = 24) between January 2010 and June 2012. Radiological and functional outcomes were compared between the 2 groups. Results: At the final follow-up, all fractures were healed, and the patients with a locking plate had a significantly better Bohler’s angle and Gissane’s angle compared with the nonlocking plate group ( P < .05). No complications occurred for the patients in the locking plate group, and 3 patients in the nonlocking plate group had implant loosening that led to loss of reduction ( P < .05). The average American Orthopaedic Foot and Ankle Society hindfoot score in the locking plate group was significantly higher than that in the nonlocking plate group ( P < .05). No statistically significant difference between the 2 groups was found regarding SF-36 ( P > .05). Conclusion: This study supports the view that locking plates may provide better stability and functional recovery in the treatment of intraarticular calcaneal fractures. Level of Evidence: Level III, comparative case series.