Analysis Of The Effect Of Different Operative Methods In The Treatment Sanders Of Type Ⅱ And Ⅲ Calcaneal Fractures

Objective:To explore the clinical effects of different surgical methods on Sanders Ⅱ and Ⅲ fractures.Methods:120 patients with calcaneal fractures who were treated in our hospital from September 2017 to January 2019 were randomly divided into three groups.Group A(27 cases)was treated with percutaneous prying reduction.For internal fixation,group B(48 cases)was treated with ordinary locking plate internal fixation,and group C(45 cases)was treated with micro-plate internal fixation.The general surgical indicators(operation time,surgical bleeding volume,hospital stay,and fracture healing time),surgical complications,and postoperative recovery were compared among the three groups of patients.Results:Compared with the operation time,the average operation time of group A patients was(45.47 ± 9.26)minutes,the average operation time of group B patients was(69.42± 7.15)minutes,and the average operation time of group C patients was(58.16 ± 8.42)minutes.Comparison of operation time between the three groups of patients P<0.05.Among them,the operation time of group A was significantly less than that of groups B and C(P<0.05),and the time of group C was significantly less than that of group B(P<0.05).The comparison of intraoperative blood loss was(25.79±5.43)ml in group A,(92.15± 15.37)ml in group B,and(76.23± 14.85)ml in group C.There were significant differences in intraoperative blood loss between the three groups(P<0.05).).Group A was significantly less than groups B and C(P<0.05).Group C was also significantly less than group B(P<0.05).There was no significant difference in fracture healing time between the three groups(P>0.05).Maryland foot score The 6-month postoperative Maryland foot score of the three groups of patients was higher than that before surgery(P<0.05).1 year postoperative Maryland scores were higher than 6 months postoperatively(P<0.05).The biomechanical indicators of the three groups of patients improved after 1 year(P<0.05).The Bohler angle(BA)and Gissane angle(GA)in type Ⅲ patients were generally greater in group B and group C than in group A(P<0.05).The calcaneus width in group Ⅲ patients was compared with that in group C compared with group A(P<0.05).Postoperative complications:The incidence of complications in treatment group A was lower than that in treatment group B and treatment group C(P<0.05).There was no significant difference between treatment group B and treatment group C(P>0.05).Conclusions:(1)Percutaneous plucking internal fixation has the advantages of small surgical wounds,small damage to soft tissues and the body,simple and convenient operation,fewer postoperative complications,and low treatment costs.The overall recovery of foot function is inferior to open internal fixation.(2)During the incision and internal fixation,the mini-plate internal fixation adopts a small sacral sinus approach,especially in type Ⅱand type Ⅲ calcaneal fractures.Due to the small wound,the amount of bleeding during the operation is significantly reduced,and the operation Complications related to incisions are relatively small,which is more advantageous for blood supply reconstruction and healing speed around bone injuries.