Objective: To investigate the methods of reduction and stable fixation for the treatment of calcaneus fracture involving posterior subtalar articular facet.
Methods: From September 2004 to September 2008, 31 cases(38 feet) of calcaneus fracture involving posterior subtalar articular facet were treated with open reduction and plate fixation through L incision. There were 24 males and 7 females, with an average age of 39.6 years ranging from 20 to 65 years. All patients underwent systematic CT-scan with coronal and horizontal images and sagittal reconstruction. The classification of the fractures by the Sanders scale showed that there were 22 of type II,14 of type III, 2 of type IV.
Results: All cases were followed up for from 12 to 36 months with an average of 25 months, and all the fractures healed without skin flap necrosis. According to the Maryland foot scoring, the total score was (96.2 +/- 8.8) on average, the results were excellent in 32 feet, good in 4 feet, fair in 2 feet.
Conclusion: The replacement of the posterior articular facet by X-ray control of Broden and open reduction and internal fixation with calcaneus plate and Schanz-Screw during the operation can keep stable of articular facet, and promote early rehabilitation of calcaneus fracture affected with subtalar joint.