Comparison Of Percutaneous Prying Reduction And Cannulated Nail Versus Tarsal Sinus Incision Reduction And Plate Internal Fixation For Calcaneal Fracture

Background and Objective: alcaneal fractures are the most common fractures of the tibia,accounting for 60% of all tibiofibular fractures,of which approximately75% are intra-articular fractures.Due to the particularity of the anatomical structure of the calcaneus and the anatomical relationship between the surrounding tissue and bone,it is difficult to reach a unified standard for the classification of calcaneal fractures,treatment options and evaluation indicators.Especially for displaced calcaneal fractures,it may lead to severe dysfunction in the later stage of the patient,such as loss of calcaneus height,increased calcaneus width and uneven articular surface,which will lead to calcaneus malformation and traumatic arthritis.There is no uniform standard for the surgical options of different fracture types.We propose a clinical comparison of percutaneous reduction and reduction of cannulated screws and sinus incision reduction plate fixation for the treatment of calcaneal fractures.The clinical treatment results of fractures were statistically analyzed and analyzed to further clarify the treatment advantages and disadvantages of the two surgical procedures for different types of fractures,and provide a reference for treatment options for clinical orthopedic surgeons.Methods: Retrospective analysis of 60 cases of calcaneal fractures treated from2015-10 to 2016-07,35 cases treated with percutaneous reduction and cannulated screw fixation(percutaneous group),and 25 cases with sacral sinus incision and reduction plate fixation Treatment(cut group).Data collection and statistical analysis were performed on the operation time,intraoperative blood loss,hospital stay,B?hler angle,Gissane angle,calcaneus height,calcane width,and Maryland score at the last follow-up.Results: The operation time,intraoperative blood loss and hospitalization time of the percutaneous group were significantly lower than those of the incision group.The incidence of incision complications was significantly lower than that of the incision group,and the difference was statistically significant(P<0.05).There were no significant differences in the B?hler angle,Gissane angle,calcaneus height,calcane width,and Maryland score at the last follow-up between the two groups inthe treatment of Sanders II and III calcaneal fractures(P>0.05).The incidence of postoperative complications in the open group(36%)was significantly higher than that in the percutaneous group(2.85%).However,in the incision group,the B?hler angle,the Gissane angle,the height of the calcaneus,the width of the calcaneus,and the Maryland score at the last follow-up were superior in the treatment of patients with Sanders type IV calcaneal fractures,and the difference was statistically significant(P<0.05).Conclusion: In the case of correct selection of surgical indications and proficiency in surgical techniques,Sanders II and III calcaneus fractures are recommended to be treated with percutaneous reduction and cannulated screw fixation.When a satisfactory reduction is achieved,the patient can be rehabilitated as soon as possible.The treatment of Sanders IV type calcaneal fractures should give priority to the treatment of sinus sinus incision and reduction plate internal fixation.At the same time,individualized treatment plan should be developed according to the patient’s own condition to minimize the incidence of surgical complications.