The Analysis Of Effect And Treatment Options Of Calcaneal Fracture

Objective:To explore the treatment options of calcaneal fracture;The curative effect of poking reduction with open reduction and internal fixation in the treatment of SandersⅡcalcaneal fracture was compared:Methods:From Sep.2005 to Sep.2007,83 cases(101 calcaneals) of calcaneal fracture were collected in hospital affiliated with Shandong tmiversity of TCM,including 6 of open fracture;Among these cases,falling injury was the main reason(73 cases),5 cases were injured by traffic accident and 5 cases were other facters.24 cases were famers,19 cases were workers:The rest were clerks,students,etc, 40 cases in all.The time paitents came to hospital after they were injured was from 1 hour to 3 weeks,4.8 days on average.According to computer tomography(CT),x-ray and observation during the operations,we used Sanders and Essex- Lopresti evaluation method to classify our cases.Abarticular fractures had 12 calcaneals,in the 89 intra-articular fractures,TypeⅠhad 6 calcaneals,typeⅡhad 36 calcaneals,typeⅢhad 30 calcaneals; typeⅣhad 17 calcaneals.All the paitents were treatment according to their actual situation.Including functional therapy,poking reduction,open reduction and internal fixation,early arthrodesis etc.SandersⅡcalcaneals were divided into poking reduction group(16 calcaneals) and open reduction group(20 calcaneals).Results:All the cases were followed up from 2 to 25 months,12.3 months on average.The excellent rate of Abarticular fractures was 91.7%,SandersⅠwas 83.3%,SandersⅡwas 86.1%,SandersⅢwas 73.3%,SandersⅣwas 41.2%.The average recovery score of poking reduction group in SandersⅡwas 76.6±15.8,the open reduction.group was 90.7±8.1.The average B(o|¨)hler's angle after operation of poking reduction group was 30.2°±1.8°,the open reduction group was 38.9°±2.9°.The average recovery score and B(o|¨)hler's angle of reduction group were better than poking reduction group(P＜0.05).Conclusions:The curative effect of open reduction and internal fixation was better than that of the poking reduction;The curative effect of serious intra-articular fractures(SandersⅣ) was not satisfied;There was a correlation between the the extent of injury and the results of treatment.The more serious the injury,the worse the treatment result.