Comparison of screw versus locking plate fixation via sinus tarsi approach for displaced intra-articular calcaneal fractures

The optimal treatment of displaced intra-articular calcaneal fractures (DIACF) is controversial. This study compared the fixation stability of screws and locking plates in DIACF treated via the sinus tarsi approach (STA).We retrospectively evaluated 118 DIACF cases treated via STA and extracted data that could affect treatment outcomes. Loss of Böhler's angle after surgery was measured to compare fixation stability.The loss of Böhler's angles was significantly smaller in the locking plate group than in the screw group (2.6 ± 2.7º vs. 5.6 ± 5.3º, P < 0.01). There was no difference in the clinical outcomes between the groups. On multivariate logistic regression analysis, screw fixation was significantly associated with loss of Böhler's angle by> 10º (odds ratio, 8.63; 95% confidence interval, 1.16-64.4; P < 0.05).Locking plate fixation is more reliable than screw fixation for preventing correction loss in DIACF treated via STA.III.