An Outcome Study of Calcaneal Fracture Treated With Plate Fixation

Abstract

Background: Displaced intra-articular fractures of the calcaneus are complex injuries that can result in persistent pain, deformity, restricted subtalar motion, and functional disability. Open reduction and internal fixation (ORIF) with plate fixation aims to restore calcaneal anatomy, posterior facet congruity, and hindfoot alignment. This study evaluated the clinical, radiological, and functional outcomes of calcaneal fractures treated with plate fixation.Methods: This institution-based prospective observational study was conducted in the Department of Orthopaedics, Malda Medical College and Hospital, from March 2025 to August 2026. Fifteen adult patients with closed displaced intra-articular calcaneal fractures were included. Patients underwent ORIF through an extensile lateral approach using a locking calcaneal plate. Fractures were classified according to the Sanders classification. Clinical, radiological, and functional outcomes were assessed at 2, 6, 12, and 16 weeks, with particular emphasis on the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot Score. Postoperative radiographs were evaluated for Böhler angle, Gissane angle, and fracture union, and complications were recorded.Results: The mean age was 35.2 ± 10.53 years (range, 19–56 years), and 13 patients (86.67%) were male. Fall from height was the most common mechanism of injury (86.67%). Sanders type II fractures constituted 53.33% of cases, followed by type III (40%) and type IV (6.67%). The mean injury-to-surgery interval was 10.6 ± 2.75 days. The mean postoperative Böhler angle was 29.07° ± 6.52° and the mean Gissane angle was 131.4° ± 6.72°. Mean radiological union occurred at 10.07 ± 1.24 weeks. At 16 weeks, the mean AOFAS score was 82.8 ± 13.06; 46.67% of patients had good and 33.33% had excellent outcomes. Complications occurred in 3 patients (20%), including wound infection in 2 (13.33%) and inadequate reduction in 1 (6.67%).Conclusion: ORIF with calcaneal plate fixation through an extensile lateral approach provided satisfactory clinical, radiological, and functional outcomes in patients with closed displaced intra-articular calcaneal fractures. Appropriate patient selection, soft-tissue recovery before surgery, anatomical reduction, stable fixation, and postoperative rehabilitation are important for favorable outcomes.