Analysis Of Curative Effect Of Percutaneous Plate Internal Fixation In Calcaneal Fracture Of Children

PART Ⅰ Analysis of curative effect of Percutaneous plate internal fixation in calcaneal fracture of childrenObjective To study the clinical effect of Percutaneous plate internal fixation in children with calcaneal fractures.Methods From January 2007 to March 2016,orthopedic ward in the Children’s Hospital of Chongqing Medical University application of Open reduction and calcaneal plate internal fixation in children with 16 patients of 19 feet,the same period non-surgical treatment of calcaneal fractures in27 patients of 38 foot,Divided into surgery group and non-surgical group.Results The Gissane angle was 127.79 ± 14.01 in the preoperative group and 123.45 ± 12.85 in the non-operative group.There was no significant difference between there two groups.Compared with the two groups,the corrected Gissane angle was 119.06 ± 11.13 in the non-operative group and 122.86 ± 9.97 in the operation group.There was no significant difference between the two groups;Compared with the corrected B?hler angle,the two groups were 21.34 ± 3.16 in the non-operative group and 30.40 ± 2.13 in the operation group,There was significant statistically difference.Maryland standard score: excellent in the surgery group 12 feet(63.2%),good 5 feet(26.3%),general 0 feet(0.0%),poor 2 feet(10.5%),MFS excellent and good rate of 89.5%;(AOFAS)assessment results: 10 feet 90-100 points excellent(52.6%),6 feet 80-89 points good(31.6%),2feet 70-79 points general(10.5%),1 foot <69 points poor(5.3%),AOFAS excellent and good rate of 84.2%;The incidence of total complications was15.8%.The excellent and good rate of MFS was 73.7%,AOFAS excellent and good rate was 68.4%,the total complication rate was 36.8%.Comparison of the two groups of data,There were statistically significant.Conclusion There was no significant difference in the Gissane angle between the treatment of non-surgical treatment and the treatment of Percutaneous plate internal fixation in children with calcaneal fractures;While the B?hler angle,the excellent and good rates were significantly different;The incidence of complications was significantly lower in the surgery group than in the non-surgical group.Therefore,children with calcaneal fractures should be actively taken surgical treatment.PART Ⅱ Prognostic difference of non-surgical treatment of calcaneal fractures with high fallObjective To study the calcaneal fractures caused by falling injuries,the prognosis of non-surgical treatment of the reasons for the difference.Methods January 2007 to March 2016,the Children’s Hospital of Chongqing Medical University,non-surgical treatment of children with calcaneal fractures in 27 patients 38 feet,23 patients 34 feet of children with falling injuries.Use AOFAS score to determine prognosis.By comparing the different age groups,different fall height,different weight,different sex,different B?hler angle of children,analyze the calcaneal fractures caused by high fall injury,non-surgical treatment after the prognosis of the reasons for the difference.To explore which children are suitable for non-surgical treatment,which children are suitable for surgical treatment.Results There were no significant differences in the prognosis of different B?hler angles at the time of injury.The non-surgical treatment of calcaneal fractures caused by high injury was: B?hler angle ≥15 ° and B?hler angle <15 °,and the excellent and good rates were71.4% and 70.0%.The excellent and good rate of B?hler angle ≥15° and B?hler angle<15°was 82.1% and 16.7%,respectively,after a year of follow-up,with significant statistical differences.The excellent and good rates of boys and girls were 70.3% and 71.4% respectively,and there was no significant difference between different sexes.Age and weight less than or equal to 10 years old,weight less than or equal to 30 kg,falling height less than or equal to 4 meters in children,the excellent and good rates by prognosis of AOFAS scores were 78.6%,83.3%,87.5%;older than 10 years of age,weight greater than 30 kg and falling height greater than 4 meters,The excellent and good rates of children were 65.0%,63.6% and 65.4%,respectively.There were significant differences in the prognosis under different effects.Conclusion There was no significant correlation between the B?hler angle at the time of injury and the prognosis in children.Therefore,the B?hler angle at the time of injury can not be used for the prognosis of calcaneal fractures in children.The restored B?hler angle after treatment has a significant correlation with the prognosis.The B?hler corner should be corrected positively.Age,weight and fall height were significantly correlated with the prognosis,The prognosis of AOFAS was 80% in children with low age,low body weight and low position;Therefore,this study believe that low-energy injury,or young high-injury children with calcaneal fractures,can be tried manual reduction,non-surgical treatment,but should follow the changes in children B?hler angle.