Clinical Study Of Percutaneous Poking Reduction And Internal Fixation Combined With Self-curing Calcium Phosphate Cement Graft In The Treatment Of Calcaneal Fractures

Objective:Through a randomized controlled trial,study the clinical efficacy and safety of self-curing calcium phosphate cement graft in the treatment of Sanders Ⅱ and Ⅲcalcaneal fractures by percutaneous poking reduction and hollow screw internal fixation to provide reference for the clinical treatment and research of calcaneal fractures.Methods:A total of 40 fresh calcaneal fracture cases admitted to the orthopedics department of Wuhu Hospital of Traditional Chinese Medicine from June 2018 to February 2020 were selected as the research subjects.According to the principle of randomize control,they were divided into experimental group and control group,with20 cases in each group.Both groups using percutaneous poking reduction with hollow screw internal fixation combining with traditional Chinese medicine and manipulative reduction.In the experimental group,the bone defect area under the articular surface after poking was treated with self-curing calcium phosphate cement graft,while the bone defect area of control group will not get special processing.Preoperative baseline data of patients in both groups,as well as the Bohler Angle,Gissane Angle,calcaneus length(L),calcaneus height(H),calcaneus width(W),loading time of the affected feet,fracture healing time,Maryland foot score,and postoperative complications were recorded for statistical analysis.Results:There was no significant difference in gender,age,BMI,fracture type and waiting time for operation between the two groups(P>0.05).The Bohler angle,Gissane angle,calcaneal length(L),calcaneal height(H),and calcaneal width(W)measured before and after operation were statistically different according to intra-group comparison(P<0.05),but there was no statistical difference between the two groups according to inter-group comparison(P>0.05).The Bohler Angle and Gissane Angle of experimental group were greater than those of the control group at 6 months and 12 months after the operation with statistically difference(P<0.05).The loading time of affected feet in the experimental group was shorter than that in the control group,with statistical difference(P<0.05).At 6 and 12 months after surgery,the Maryland foot score of the experimental group was higher than that of the control group,and the difference was statistically significant(P < 0.05).Conclusion: Percutaneous poking reduction with hollow screw internal fixation combing self-curing calcium phosphate cement graft of Sanders Ⅱ,Ⅲ calcaneal fractures to be effective in preventing the recollapse of the articular surface and the reloss of the Bohler angle and Gissane angle,and does not increase the incidence of postoperative complications,and can facilitate the recovery of the foot’s function during the long-term process,which is a relatively safe and effective treatment.