Fixation for calcaneal tuberosity fracture (beak fracture) using preformed “L-shape” hook plate

TL;DR

This paper introduces a new surgical method using an L-shaped hook plate to treat a specific type of heel bone fracture, showing good recovery and no complications in 15 patients.

Contribution

The use of a preformed L-shaped hook plate for Beavis type II calcaneal tuberosity fractures is presented as a novel surgical technique.

Findings

All 15 patients achieved clinical healing in an average of 10.5 weeks with no postoperative complications.

Functional outcomes improved significantly, with AOFAS-AH scores increasing from 24.0 to 93.8 and VAS pain scores decreasing from 5.7 to 1.3.

Abstract

Surgical management of calcaneal tuberosity fractures is challenging, as patient outcomes can be compromised by skin flap necrosis and implant failure. We propose a technique utilizing a prefabricated L-shaped hook plate, which represents an innovative clinical orthopedic surgical approach.

In this retrospective study, patients with Beavis type II calcaneal tuberosity fractures underwent internal fixation using a preformed “L-shape” hook plate (2015–2020). Data on operative time, complications, and healing time were recorded. Functional outcomes were evaluated using the Ankle Society Ankle-Hindfoot (AOFAS-AH) and Visual Analog Scale (VAS) pain scores.

This study included 15 patients (6 females/9 males; mean age 52.9 ± 11.2 years) with calcaneal tuberosity fractures who underwent internal fixation with a preformed “L-shape” hook plate. At a mean follow-up of 17.1 ± 6.0 months, no postoperative complications—including wound issues, infection, nerve injury, or fixation failure—were observed in any patient. All 15 cases achieved clinical healing at an average of 10.5 weeks (range: 8–13). Functional outcomes improved significantly, with the AOFAS-AH score increasing from 24.0 ± 9.9 preoperatively to 93.8 ± 5.2 postoperatively, and the VAS score decreasing from 5.7 ± 0.6 to 1.3 ± 0.5 (p < 0.001 for both).

Emergency open reduction and internal fixation is recommended for calcaneal avulsion fractures to prevent flap necrosis. For Beavis type II fractures, the preformed L-shaped hook plate represents a novel and promising alternative, demonstrating favorable early clinical outcomes in this initial series.

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