| Objective:To discuss the results of treating sandersâ…¢fracture of calcaneus by open reduction internal fixation and precutaneous reduction by leverage internal fixation with Kirschner wire. To analysis the factors that impact therapeutic effect of operating, to summarize experience,to improve the therapeutic effect, to decrease complication and improve life quality, to guide clinic therapy.Methord:We treated 58 cases of sandersâ…¢fracture of calcaneus from 2007.10-2009.3 in the traditional Chinese medical hospital of hubei province, the Wuhan General Hospital.30 cases were treated with titanium plate (group A)and 28 cases with Kirschner wire (group B). Record parameters of preoperative hospitalization time, operation time, hospitalization expenses, intraoperative fluoroscopy frequency. By comparing X-ray of the four parameters (BOlher angle, Gissane angle, Peries angle and calcaneal height) of preoperative and postoperative, as well as each group postoperation of Maryland score.According to data analusis by SPSS. There were no significant diffrernce in the sex, age and X-ray of the four parameters between the two groups preoperative (P> 0.05). there was comparable.Rusults:All cases but 3 (group B) were found exudate from pinhole, and cured by taking orally antibiotics. All of other cases especial group A were primary healing, there were no complication of skin necrosis. There were significant difference between two groups in preoperative hospitalization time, operation time and hospitalization expenses, group B was better than group A, but group B's intraoperative fluoroscopy frequency was much more than group A's. There were significant difference between two groups in BOlher angle, Gissane angle, Peries angle and calcaneal height of preoperative and postoperative. Group B after one year of operation, it would significantly reduce the loss of the calcaneus shape, especially the calcaneal height. Group A was better than group B of Maryland score after one year of operation. Group A was much better than Group B in recovery of function.Conclusion:To treat sandersIII fracture of calcaneus, open reduction internal fixation was better than percutaneous reduction by leverage internal fixation on therapeutic effect. But open reduction internal fixation is high on the technique requirements, and patients had heavy economic burden. Percutaneous reduction by leverage internal fixation with Kirschner wire is a effecttive therapy on the condition of technique is immaturity and money is poor. Proactive preoperotive preparation, suitable surgery occasion, "no touch" technique, full-thickness saturation, smoking cessation during hospital stay could ensure operative incision and fracture primary healing. |
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