Efficacy Comparison Of Lateral Double-incision And Conventional L-shaped Approaches For Treatment Of Displaced Intra-articular Calcaneal Fractures

Objective: To compare the clinical efficacy of lateral double-incision and conventional L-shaped approaches for treatment of displaced intra-articular calcaneal fractures.Methods: A retrospective analysis was conducted of the 67 patients with displaced intra-articular calcaneal fractures who had been treated by open reduction and plate internal fixation from August 2018 to January 2020.Of them,31 were treated via the lateral double-incision approach(double-incision group)and the other 36 via the Conventional L-shaped approach(conventional group).The clinical outcomes and complications were compared between the two groups.Results: All of the cohort patients were followed up for 12-26months(average,18.94±3.34 months).The time between injury and operation,operation time,intra-operative blood loss and hospitalization time in double-incision group were significantly less than those in conventional group(all P< 0.05).The incidence of wound healing complications was 3.23% in the double-incision group versus 25.00% in the conventional group(P=0.032).There were no significant differences in width,height,length,B(?)hler angle and Gissane angle of the calcaneus between the two groups at the preoperative and final follow-up(P>0.05).American Orthopedic Foot Ankle Society(AOFAS)ankle-hind foot score at the final follow-up was87.58±7.42 in the double-incision group versus 87.14±7.27 in the conventional group(P=0.807).Conclusions: Compared to conventional L-shaped approaches,lateral double incision for treated of displaced intra-articular calcaneal fractures achieved decreased surgical trauma and reduced the incidence of postoperative wound healing complications without significant difference postoperative radiological outcome and affected foot function.