| Objective:Through retrospective studies,patients with Sanders type Ⅱ and Sanders type Ⅲ calcaneal fractures admitted to the Department of Orthopedics of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were collected,and the treatment effects and advantages and disadvantages of transtarsal sinus tarsi approach incision reduction steel plate internal fixation(STA)and translateral L-shaped extensile lateral approach incision reduction steel plate internal fixation(ELA)were discussed,so as to provide reference for the selection of clinical surgical methods.In addition,the clinical efficacy of self-prepared extensor tablets in the Affiliated Hospital of Shandong University of Chinese Medicine on the recovery of foot function after calcaneal fracture is discussed,which provides reference and theoretical basis for the clinical application of traditional Chinese medicine.Methods:1.Through the big data search engine of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,the patients with calcaneal fracture admitted to the hospital and treated with surgery between March 2019 and March 2022 were collected,and a total of 93 patients classified as Sanders type Ⅱ and Ⅲ were determined according to X-ray,CT and three-dimensional reconstruction,as the research object of this trial,13 patients who did not meet the criteria were excluded,a total of 80 patients were included in this study,and the above patients were divided into two groups A and B according to the surgical method.Group A used transtarsal sinus tarsi approach incision reduction steel plate internal fixation(40 cases),and group B used translateral L-shaped extensile lateral approach incision reduction steel plate internal fixation(40 cases),and conducted follow-up for at least 6 months after discharge,recorded the patient’s gender,age,height,weight,fracture classification,and injury cause as general baseline indicators,recorded,observed and compared the waiting time for surgery(time from injury to surgery),operation time,length of incision,intraoperative blood loss,postoperative drainage,hospital stay,fracture healing time,Bohler angle,Gissane angle,calcaneal length,height,width,complication rate,VAS score,and AOFAS ankle and hindfoot function score.2.A total of 80 patients with calcaneal fracture admitted to the hospital from July 2019 to August 2022 were collected,and randomly divided into observation group(40 cases)and conventional group(40 cases)according to the chronological order of admission,both groups underwent internal fixation of the steel plate through the lateral "L" approach,and after the operation,they were given conventional treatments such as blood circulation and stasis,swelling and pain relief,and anti-infection,and the observation group took 5 shenjin tablets,Tid,PO on the basis of conventional treatment,and the medication cycle was 4weeks.The postoperative VAS score and ankle and hindfoot AOFAS scores of the two groups were observed.Results:1.All 80 patients were followed up for more than 6 months.There was no significant difference in the basic preoperative data(sex,age,height,weight,cause of injury,fracture classification,etc.)between the two groups A and B(P>0.05),and the data were comparable.Group A’s waiting time,intraoperative blood loss,postoperative drainage,incision length,and hospital stay were significantly different < those in Group B(P<0.01),and Group A’s VAS score on the day after surgery was < Group B with a statistically significant difference(P<0.05).In addition,there were no significant differences in operation time,postoperative Bohler angle,Gissane angle,calcaneus length,width,height,and AOFAS score at 6 months after surgery(P>0.05).One patient in group A had symptoms of gastrocnemic nerve injury;One patient developed subtalar joint pain;The postoperative complication rate in group A was 5.00%.In group B,2 patients had marginal necrosis,and 1 case had deep infection complicated by chronic osteomyelitis;One patient had foot skin ulceration and two had subtalar joint pain.The incidence of postoperative complications in group B was 15.00%,which was higher than that in group A,but there was no significant difference(P>0.05).Neither group A nor B had serious complications such as neurovascular and tendon injury after surgery.2.The general baseline data of the observation group(shenjin tablets group)and the conventional group were compared with P>0.05,and the data were not statistically significant and comparable.Compared with the conventional group,the VAS score and AOFAS score at 1 week and 4 weeks after surgery and AOFAS score at 3 months after surgery in the observation group improved significantly(P<0.05),and there were no drug-related adverse reactions in either group.Conclusions:1.The results of this study showed that the treatment of Sanders type Ⅱ and type Ⅲ calcaneal fractures with transtarsal sinus tarsi approach incision reduction steel plate internal fixation(group A)and translateral L-shaped extensile lateral approach incision reduction steel plate internal fixation(group B)could achieve satisfactory efficacy,and the postoperative functional recovery was good.STA can effectively reduce surgical trauma,shorten operation time,reduce intraoperative blood loss,reduce postoperative pain,and reduce the incidence of complications.STA has advantages over ELA.However,this study is a retrospective study,with a small number of cases and insufficient follow-up time,which cannot fully compare the long-term imaging results and functional scores of the two groups,and the long-term efficacy needs to be further studied and evaluated.2.Shenjin tablets have obvious efficacy in improving ankle and hindfoot function after calcaneal fracture surgery,and are worthy of clinical promotion and application. |
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