Clinical Study On Calcaneal Fracture (Sanders Ⅳ) Treated With Manipulative Reduction And Mini-incision, Internal Fixation With Kirschner Wire

ObjectiveTo evaluate the effectivity and security of the treatment of manipulative reduction and mini-incision, internal fixation with kirschner wire.MethodsThe prospective, randomized, compared clinical trial design method was adopted. From March2011to September2011,60patients which were diagnosed as intra-articular calcaneal fractures (Sanders Ⅳ), were employed to made study in Foshan hospital of traditional Chinese medicine, according to the inclusion criteria and exclusion criteria. According to general conditions such as gender, age, cause of injury, visiting time,60cases were divided into experimental group, control group in accordance with the method of simple randomization at proportion of1:1. Two groups were be cured the same conventional and basic therapy. Experimental group was treated with manipulative reduction and mini-incision, internal fixation with kirschner wire, and control group was treated by lateral L-shaped incision, open reduction and internal fixation with AO steel plate. Two groups were be cured the same conventional and basic therapy after operation before discharge from hospital. Comparison of two groups of hospital costs, operation time and hospitalization time. The Bohler’s ankle, Gissane ankle and the mid-breadth of calcaneus would be measured when3months,6months,8months after the treatment. The fracture healing time, the joint range of motion, the score of Maryland podalic function table and postoperative complication would also be checked. The data was made with statistical analysis, and the change of outcome measures was compared.ResultsAll patients were received a follow-up to8months. All fractures are achieved clinical union. There were2cases suffering incision cutaneous necrosis after operation in the control group, were treated with skin grafts. There were no statistically significant differences in general conditions between the two groups (P>0.05), which suggested that the two groups were comparable. There were statistically significant differences in hospital costs, operation time, hospitalization time and postoperative complication between the two groups (P<0.05), experimental group was better than control group. Except3months postoperatively control group was better than the experimental group in the joint range of motion (P<0.01). There were no statistically significant difference in Bonier’s ankle, Gissane ankle, the mid-breadth of calcaneus and the joint range of motion after3months,6months and8months postoperatively between the two groups (P>0.05), and the same of the score of Maryland podalic function table after postoperative8months, which suggested that the experimental group and the control group had no significant difference in clinical therapeutic effect.ConclusionMini-incision combined with manipulative reduction and pinning internal fixation with Kirschner wire treatment of calcaneal fracture of type Sanders Ⅳ is a better way, compared with control group, hospitalization low cost, small operation wound, simple operation, shorter hospitalization time etc, in the clinical efficacy of the same circumstances, can effectively prevent postoperative the occurrence of complications, can reduce the burden and pain of patients, is worth popularizing.