Clinical Observation On The Treatment Of Sanders Type â…¡ Calcaneal Fractures With Fixed Reduction Plate Fixation And Limited Incision Hollow Nail Fixation

Objective:To compare and analyze the therapeutic effect of the open r eduction and plate-screw fixation and the limited open reduction and cannulated screw fixation in the treatment of SandersII calcaneal fra cture.Methods:From June 2013 to March 2015,40 patients with SandersII cal caneal fracture in the Orthopaedics Department of the Affiliated Hosp ital of Chengdu University of Traditional Chinese Medicine and the Se cond People’s Hospital of Chengdu were enrolled according to inclusio n and exclusion criteria. The cohort of patients was divided into two groups-group A and group B, and each group had 20 cases. The open re duction and plate-screw fixation with a L-shaped lateral incision was performed on group A, and the limited open reduction and cannulated screw fixation on group B. We analyzed and compared the width, height, Bohler’s angle, Gissanes angle, incision length, healing time and A OFAS score at one month, three months, six months and twelve months a fter surgery.Results:All patients were followed up within 12 to 18 months. Statist ics software SPSS19.0 was adopted to in contrasting and analysis the data, including gender, age, preoperative width, height, Bohler’s an gle, Gissanes angle of calcaneus and healing time. There was no signi ficant difference between the two groups (P> 0.05). Postoperative wi dth, height, Bohler’s angle, Gissanes angle, healing time and AOFAS score at six months and twelve months were also analyzed. There was a lso no significant difference between the two groups (P> 0.05). The incision length in group A was 10; 77±0.89, group B 5.31±0.65; AOFAS score at postoperative one month and three months in group A was 54. 15±3.08 and 54.15±3.08, group B 54.65±2.758 and 62.30±3.19; 7 cas es of postoperative complication were found in group,2 cases in grou p B. There was significant difference between the two groups (P<0.0 5).Conclusion:The open reduction and plate-screw fixation, with more ind ications, a clear picture of fracture end good efficacy, has more com plications, more harm to soft tissue and incision is not beneficial t o early postoperative functional recovery. The limited open reduction and cannulated screw fixation, with small incision, less harm to sof t tissues, less complication, short recovery time and prone to accept, restricts the reduction of fracture fragments, needs higher technica 1 requirements and has less fixation intensity. Both the open reducti on and plate-screw fixation and the limited open reduction andcannula ted screw fixation have advantages and disadvantages in the treatment of SandersⅡ calcaneal fracture.