Analysis Of Clinical Efficacy Of Sinus Tarsi Approach In The Treatment Of Sanders Ⅱ～Ⅲ Calcaneal Fracture

ObjectiveTo investigate the clinical effect of open reduction and internal fixation via tarsal sinus approach in the treatment of intra-articular calcaneal fractures.MethodsSeventy-one patients(75 cases)with calcaneal Sanders Ⅱ～Ⅲ fractures admitted to the First Affiliated Hospital of Zhengzhou University from September 01,2018 to September 01,2019 were treated with open reduction and internal fixation through tarsal sinus incision(observation group).A retrospective analysis was performed on 67 patients(69 cases)with calcaneal Sanders Ⅱ～Ⅲ fractures admitted to our hospital from September 01,2017 to August 31,2018(control group).The patients in this group were treated with lateral L-shaped incision approach.Two groups of patients before operation showed swelling of hind foot,and ankle joint activity was limited,sense of pain was obvious as well;X-ray films(axial+lateral)and CT plus three-dimensional reconstruction were taken before operation in both groups.The length of incision,intraoperative blood loss,operation time,fracture healing time and postoperative drainage were recorded.The clinical efficacy of the two surgical approaches in the treatment of calcaneal fractures was evaluated by comparing the VAS score,AOFAS score,imaging parameters and postoperative complications between the observation group and the control group.ResultsA total of 138 patients(144 cases)in the two groups were successfully operated and followed up.The follow-up time of the observation group was 12-16 months(average 13.6 months),and that of the control group was 12-18months(average 15.2months).Compared with the control group,the observation group had shorter operation time,less intraoperative blood loss,shorter incision length,lower VAS score in the first week after operation and lower incidence of postoperative complications,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in the operation time,fracture healing time,postoperative Bohler angle,Gissane angle,Langre angle,calcaneal width and height recovery degree,VAS score at 1 year after operation and AOFAS score between the two groups(P>0.05).Conclusion1.There was no significant difference in the recovery of ankle function and anatomical parameters between the tarsal sinus incision approach and the lateral L-type incision approach in the treatment of Sanders Ⅱ-Ⅲ calcaneal fractures.2.The tarsal sinus incision approach has the advantages of less trauma,faster pain relief and less postoperative incision complications.