The Value Of Using External Fixator Temporarily In The ORIF Treatment Of The Medial Shortening Type Calcaneal Fractures

objective To explore the value of using external fixator temporarily in the ORIF treatment of the medial shortening type calcaneal fractures.Methods From2011December to2013March,15cases including16foots with medial shortening deformity were treated with open reduction plate internal fixation, through the extensile "L" lateral approach. According to the Sanders classification, there were8cases of typeⅢ including9foots, while7cases of type Ⅳ including7foots. All patients were preferentially treated with conventional methods, and if that way were not effective, an external fixator was used in the medial side temporarily in order to improve the medial shortening deformity, meanwhile pay attention to correct the articular surface collapse, the calcaneal widening and other deformity. Record and compare the Bohler’s angle, the Gissane’s angle, the height of the calcaneus and the rate of the calcaneal shortness preoperative and after each procedure.Results The group treated with conventional methods showed significant improvements in the Bohler’s angle and the rate of the calcaneal shortness with preoperative group (P<0.05,Tab3), while there is no difference in the Gissane’s angle and the height of the calcaneus (P>0.05, Tab3). There were significant difference in the Bohler’s angle, the Gissane’s angle, the height of the calcaneus and the rate of the calcaneal shortness between the preoperative group and the group treated with external fixator (P<0.05, Tab5). The group treated with conventional methods showed significant improvements in the Bohler’s angle, the Gissane’s angle and the rate of the calcaneal shortness with the group treated with external fixator (P<0.05, Tab4), while there is no difference in the height of the calcaneus (P>0.05,Tab4). Fellow-ups lasted from2to16months with an average of9months and the clinical results were evaluated by the Maryland foot score, the excellent and good results of the Sanders type III group were88.9%, while the Sanders type Ⅳ group were85.7.0%, and the total excellent and good results were87.5%.Conclusions The value of using external fixator temporarily in the ORIF treatment of the medial shortening type calcaneal fracture is affirmatory. It can effectively correct the medial shortening, restore calcaneal anatomy, and promote the operative effect.