Analysis Of Postoperative Long-term Pain Causes Of Calcaneal Fracture

Objective: To retrospectively analyze and summarize the clinical characteristics of patients with postoperative pain of calcaneal fracture in the Second Affiliated Hospital of Nanchang University,explore the causes of postoperative long-term pain of calcaneal fracture,provide theoretical reference for clinical surgical treatment of calcaneal fracture,reduce the incidence of postoperative pain and other complications,and improve patient satisfaction.Methods: In this study,81 patients who underwent open reduction and internal fixation for calcaneal fractures in the Second Affiliated Hospital of Nanchang University from September 2018 to February 2021 were collected and concluded by retrospective analysis,followed up for at least one year,and their VAS scores(visual analogue scoring method)one year after surgery were recorded.The mean score ≥3was defined as pain group(24 cases),and < 3 was defined as non-pain group(57cases).Data on postoperative reduction effect of Bohler Angle and Gissane Angle,reduction effect of posterior articular surface,correction effect of calcaneus varus,height and width of calcaneus,fixation of calcaneus talus process and other data were collected.Data were analyzed using SPSS26.0 software.T-test was used for intra-group and inter-group comparison,and multivariate regression analysis was performed.Chi-square test was used to compare counting data,and P < 0.05 was considered statistically significant.Results:There were statistically significant differences in poor reduction of Bohler Angle and Gissane Angle,poor reduction of posterior articular surface,poor correction of calcaneus varus,poor reduction of calcaneus height and width,and lack of fixation of calcaneus aptalus process between the pain group and the non-pain group(P < 0.05).Logistic multivariate analysis showed poor reduction of Bohler Angle and Gissane Angle(P < 0.001,OR=0.003,95%CI 0.000-0.059),poor reduction of posterior articular surface(P < 0.001,OR=0.005,95%CI 0.000-0.094),varus of calcaneus(P=0.004,OR=0.019,95%CI 0.001-0.287),poor heiht and width of calcaneus(P < 0.001,OR=0.004,95%CI 0.000-0.073)and lack of fixation of the calcaneal aptalus process(P=0.001,OR=0.013,95%CI 0.001-0.174)were independent risk factors for postoperative long-term pain of calcaneal fractures.Conclusion: Poor reduction of Bohler Angle and Gissane Angle,poor reduction of posterior articular surface,poor correction of calcaneus varus,poor reduction of calcaneus height and width,and lack of fixation of calcaneus aptalus process are the causes of postoperative long-term pain of calcaneus fracture.