| Background:The calcaneus is the largest appendage in the human body,and the calcaneus mainly plays the role of support,weight bearing and auxiliary activities.Calcaneal fracture is also a common fracture in clinical,accounting for about 1-2% of adult fractures,accounting for 30% of foot fractures,and about 70% of fractures are suffered articular surfaces,and fractures of articular surfaces are usually difficult to deal with.There is no consensus on the treatment of calcaneal fractures,but for intra-articular fractures,it is generally accepted that complications such as traumatic arthritis are more common when suffered conservative treatment.Surgical modalities include percutaneous minimally invasive,partial incision,and traditional lateral L incision.Clinically,lateral L-shaped incision plate screws were used to fix calcaneal fractures,and postoperative complications,skin necrosis and infection were common.Tarsal sinus incision combines the advantages of percutaneous minimally invasive and traditional lateral L incision,and has achieved good efficacy and gradually gained clinical recognition.Strong fixation is in need to prevent the loss of reduction and early exercise,tarsal sinus incision includes screw plate internal fixation and simple screw internal fixation,but there are few studies comparing the two internal fixations.Objective:This article summarizes the pathogenesis,disease characteristics,diagnosis,classification and treatment of calcaneal fracture,and compares and studies the clinical efficacy and biomechanical characteristics of two internal fixation methods of tarsal sinus incision in the treatment of Sanders III calcaneal fracture,and discusses the advantages of the clinical application of simple nails in the treatment of Sanders III calcaneal fracture.The finite element analysis was used to verify the good stress distribution and stress performance of Sanders III calcaneal fracture by pure nails.MethodsA retrospective analysis was performed on the 100 patients with Sanders III calcaneal fracture admitted to the Department of Trauma and Orthopedics of China-Japan Union Hospital of Jilin University from September 2017 to August2021.The patients were divided into two groups according to the treatment modalities:group A was underwent simple screws with tarsal sinus incision(42 cases);Group B was underwent plate with tarsal sinus incision(58 cases).SPSS software was used to compare and analyze the length,width,height,Bolher angle and Gissane angle of the calcaneus A and B before and after the operation of the two groups.The American Society of Orthopaedic Foot and Ankle Score(AOFAS)and Visual Analogue Pain Score(VAS)were performed at the last follow-up visit,and the AOFAS score was used to obtain a good rate.P<0.05 indicates a statistically significant difference.Results:There were no significant differences in Gissane angle,Bolher angle,length and height of the calcaneus between the two groups.The AOFAS score,VAS score and excellent rate of group A were better than those of group B,but there was no statistical difference between the two.The complication rate in group A was lower than that in group B,and the difference was statistically significant(p<0.05).In terms of calcaneal and internal fixation stress,group A performed lower than group B,while group B performed more stable than group A in terms of overall calcaneal displacement and fracture suture displacement.Conclusion:Tarsal sinus incision in the treatment of calcaneal fracture has achieved good efficacy while effectively reducing the incidence of complications.Simple screw internal fixation provides a stable environment for calcaneal fractures while bringing fewer complications,in line with the minimally invasive concept of calcaneal fractures. |
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