The Efficacy Study Of Bone Grafting In Sanders Ⅲ-Ⅳ Calcaneal Fractures With Prying Reduction And Internal Fixation

Objective:By analyzing the clinical data of bone grafting and non-bone grafting in closed prying reduction and hollow nail internal fixation for Sanders Ⅲ-Ⅳ calcaneal fracture,to explore the clinical effect of closed prying reduction hollow cannulated nail fixation combined with autogenous iliac bone grafting in the treatment of Sanders typeⅢ-Ⅳ calcaneal fractures,provide theoretical data with clinical significance for the treatment of calcaneal fractures.Methods:In this study,64 Sanders Ⅲ-Ⅳ calcaneal fracture patients who met the orthopedics department of Wuhu Traditional Chinese Medicine Hospital from January 2016 to February 2019 were selected.Among them,30 cases in the bone graft group and 34 cases in the non-bone graft group were all single-foot calcaneus fractures.Record the X-ray measurement indexes(Bohler angle,Gissane angle,calcaneus length,calcaneus width,calcaneus width,calcaneus height)of the two groups before operation,immediately after operation and 3 months after operation,the occurrence of postoperative complications and 1 year Maryland foot function score,and statistical analysis.Results:1.X-ray measurement index:①There was no significant difference between the two groups before and immediately after operation(P>0.05);②There was no statistically significant difference in calcaneus length between the two groups before and after surgery(P>0.05),and there were statistically significant differences in Bohler angle,Gissane angle,calcaneus width and calcaneal height(P<0.05);③There was a statistically significant difference in the Bohler angle and calcaneus height between the two groups after 3 months of operation(P<0.05),but there was no statistically significant difference in the Gissane angle,calcaneal length,and calcaneal width(P>0.05).2.The incidence of postoperative complications in the two groups:There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05).3.Maryland foot function score at 1 year after operation between the two groups:There was no significant difference in postoperative foot function score between the two groups(P>0.05).Conclusion:Treatment of Sanders Ⅲ and Ⅳ calcaneal fractures with closed prying reduction and hollow nail internal fixation,regardless of bone grafting,can better restore the anatomical shape of the calcaneus.The clinical effect is satisfactory.But the reduction can be maintained by autologous iliac bone grafting The subtalar articular surface can reduce post-operative fracture re-collapse and loss of Bohler angle,and reducing the occurrence of postoperative heel-traumatic arthritis.