Open Reduction And Internal Fixation With Or Without Bone Graft Forintra-articular Calcaneal Fractures:a Meta-analysis

Objective:To compare the clinical effects of open reduction and internal fixation with or without bone graft in the treatment of displaced intra-articular calcaneal fractures,and then to find out which treatment method is better to guide clinical practice.Methods:The following electronic database was searched:Pub Med,Embase and Conchrane Libray database.The time limit was from the establishing of the database to April 2017.The quality evaluation and data extraction were carried out by two researche-rs separately.When the two opinions were not consistent,the third researcher was needed to intervene and discuss the decision together.Main evaluation index included excellent rate of foot function,Bohler angle,Gissane angle,calcaneus height,SF-36.Secondary evaluation index included incision necrosis or dehiscence,wound infection and osteoarthritis.The Review Manager5.3 software was used for Meta-analysis.Results:There were seven articles in qualitative and quantitative synthesis,with 824 cases in two groups and 399 in bone graft group.The Meta analysis showed that bone graft group and non bone graft group were not statistically significantly different at the end of follow-up(excellent rate of foot function,Bohler angle,Gissane angle,calcaneus height,incision necrosis or dehiscence,wound infection and osteoarthritis).There was statistically significant difference in SF-36.Conclusion:For the displaced intra-articular calcaneal fractures,There was no statistical difference between bone graft and without bone graft.Such as the AOFAS ankle function score,Maryland foot function score,the angle of Bohler’s,the height of calcaneus,the infection of incision,the necrosis and dehiscence of incision after operation,and the incidence of osteoarthritis after operation.There were significant statistical differences between bone graft and without bone graft on the SF-36 score,and bone graft were likely to get higher scores.But considering the cost of bone graft or the pain in donor area,bone graft is not necessary for intra-articular calcaneal fracture with displacement.