| Objective: Analyzing the postoperative B(?)hler angle,the Gissane angle change,and the AOFAS score and other indicators,To compare the clinical effects of traditional open reduction with plate fixation and percutaneous reduction with external fixation reduction in the treatment of calcaneal fractures.Methods: A retrospective collection of 50 patients with calcaneal fractures who were treated in the Department of Orthopedics of Qingdao Municipal Hospital from September 2018 to August 2020 were used as research objects.According to different surgical methods,they were divided into control group(25 cases)and experimental group(25 cases).Perfect the preoperative examination,clarify the purpose of the operation and select the correct time of the operation.In the control group,patients underwent intraspinal or epidural anesthesia followed by an “L”-shaped incision in the lateral aspect of the calcaneus,the fracture was reduced,and internal fixation with locking plate screws was performed.The experimental group underwent intraspinal or epidural anesthesia,with the help of the "C" arm,a Schanz nail was inserted percutaneously in the upper posterior border of the calcaneus,and the locking plate was externally fixed by lever and reduction.Handbook.All patients received broad-spectrum antibiotics to prevent infection within 48 hours of surgery,low-molecular-weight heparin was used to prevent deep vein thrombosis in the lower extremities 6 hours after surgery,and combined oral analgesics were administered IVs at 6 hours.12 and 24 hours after surgery,patients who can tolerate pain are supplemented with unplanned analgesics.On the first day after surgery,adequate functional training was initiated in bed,gradually moving from passive to active activity to avoid joint stiffness and deep vein thrombosis.The lateral and axial radiographs of the calcaneus were reviewed on the third day after surgery to confirm that the plate was reliably fixed and the fracture was not displaced.Getting out of bed is prohibited within 2 weeks after surgery.After 6 weeks after surgery,you can use crutches or walkers for partial weight training,12 weeks after surgery for full weight training and the steel plate can be removed in 8-12 months.The patients’ postoperative recovery was regularly monitored(follow-up time ≥ 6 months)and the clinical efficacy,advantages and disadvantages of the two surgical methods were compared.The indicators observed include operating time,intraoperative blood loss,hospital stay and postoperative.pain score(VAS scoring system),changes in B(?)hler and Gissane angles before and after surgery,healing of the fracture in 6 months,recovery of heel function(according to the AOFAS ankle-hindfoot scoring system for evaluate the effect of surgery)and complications The incidence of the disease.Results: Comparing the postoperative clinical data of the experimental group and the control group,the experimental group had a relatively short operation time and less intraoperative blood loss,the difference was statistically significant(p ﹤ 0.05).There was little difference in postoperative pain score between the two groups and the difference was not statistically significant.In the six to eight hours postoperatively,the experimental group had less pain than the control group,and the difference was statistically significant(p﹤0.05).The difference between the two groups of patients in the B(?)hler angle and the Gissane angle before the operation was not statistically significant and the postoperative difference was not statistically significant(p> 0.05).Clinical experiments show that the two groups of patients undergoing different surgical procedures have good treatment results for B(?)hler’s angle and Gissane’s angle.When applying two different surgical methods to patients with two surgical treatments,there was no significant difference in the score after the fracture,and the difference was not statistically significant(p> 0.05).The excellent and good rates of the two groups of patients after surgery were similar and the difference was not statistically significant(p> 0.05).The clinical data showed that the incidence of complications in the experimental group was significantly lower than in the control group.Conclusion: Through the clinical comparison between open reduction treatment and closed reexternal treatment,there is no significant difference between the clinical effects of the two treatment methods and the patient’s condition has improved effectively.The use of closed reduction and external fixation to treat calcaneal fractures has a short operating time,less bleeding,a short hospital stay,and a low complication rate.It can effectively reduce the patient’s pain and avoid secondary surgery to remove the internal fixation.is generally better than traditional surgery Open reduction and internal fixation. |
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