Observation On The Curative Effect Of Zhang’s Manual Technique For Reduction Combined With Poking Fixation For Sanders Ⅱ And Ⅲ Calcaneal Fractures

Objective:To evaluate the clinical efficacy and value of Zhang’s manual technique for reduction combined with poking fixation for Sanders Ⅱ and Ⅲ calcaneal fractures compared with open reduction and internal fixation for Sanders Ⅱ and Ⅲ calcaneal fractures.Methods:50 patients with Sanders Ⅱ and Ⅲ calcaneus fractures of the were enrolled in this study.All patients patients were randomly divided into two groups:25 cases were treated with Zhang’s manual technique for reduction combined with poking fixation(experimental group),and the other 25 cases were treated with open reduction and internal fixation(control group).Two groups were measured in preoperative and postoperative imaging data(Bohler’s,Gissane’s angle),The Incision complications were observed,hospitalization time and expenses were observed,The functional evaluation was performed by Maryland foot score,and the clinical effects of the two treatments were comp ared.Result:1.All patients were followed up for 6 months.There was no significant difference between the two groups in gender,age,follow-up time,injury factors and fracture classification.2-Six months after the operation the Maryland foot score:the experimental group 86.00±11.48 scores,the control group 87.48±10.38 scores,the total scores were signifi cant difference in statistical analysis(P>0.05).The experimental group:14 cases were excellent,good in 6 cases,fair in 4 cases and poor in 1 case;the control group:16 cases were excellent,good in 6 cases,fair in 2 cases and poor in 1 case;excellent rate of the two groups:the experimental group 80.00%;the control group 88.00%;There were no statistically significant difference between the two groups.3.Bohler’s angle:preoperative:the Experimental group:11.56±8.56°,the control group 9.36±10.89°;postoperative:the experimental group 23.02±9.00°,the control group 23.96±8.40°;the difference between the two groups before and after the operation:the experimental group 11.46±9.88°,the control group 14.60±12.15°.Gissane’s angle:preoperative:the experimental group:130.58±11.36°,the control group 133.56±9.68°;postoperative:the experimental group:124.36±10.41°,the control group 125.06±10.20°;the difference between the two groups before and after the operation:the experimental group-6.22±12.68°,the control group-8.5±12.35°.There was no significant difference between the two groups in preoperative Bohler’s angle(P>0.05).There was no significant difference between the two groups in postoperative Bohler’s angle(P>0.05).The experimental group were significant difference in Bohler’s angle between before and after treatment(P<0.05).The control group were significant difference in Bohler’s angle between before and after treatment(P<0.05).There was no significant difference between the two groups before and after treatment with Bohler’s angle difference(P>0.05).There was no significant difference between the two groups in preoperative Gissane’s angle(P>0.05).There was no significant difference between the two groups in postoperative Gissane’s angle(P>0.05).The experimental group were significant difference in Gissane’s angle between before and after treatment(P<0.05).The control group were significant difference in Gissane’s angle between before and after treatment(P<0.05).There was no significant difference between the two groups before and after treatment with Gissane’s angle difference(P>0.05).4.Incision complications:the experimental group 0 case,the control group 6 cases.Incision complications were statistical difference between the two groups(P<0.05).5.Hospitalization time:the experimental group 10.16±1.65days,The control group 19.84±1.99days.Hospitalization expenses:the experimental group 8663.42±546.90yuan,The control group 18777.64±1090.80yuan;There were significant difference between the two groups in hospitalization time and expenses(P<0.05).Conclusion:For the Sanders type Ⅱ and Ⅲ fractures of the calcaneus,the use of the Zhang’s manual technique for reduction combined with poking fixation and open reduction and internal fixation were no difference in clinical efficacy six months postoperatively,but Zhang’s manual technique for reduction combined with poking fixation can reduce incision complications,shore Hospitalization time and save Hospitalization expenses.