Comparative Study Of Therapeutic Effect :closed Reduction With Poking And Open Reduction With Internal Fixation For The Treatment Of Displaced Intra-Articular Calcaneal Fractures

Objective: In this prospective study, we using the methods of percutaneously introduced Kirschner wires(K-wires),Versus Open Reduction and Internal Plate Fixation(ORIF) with nonlocking compressive plate and locking compressive plate for closed,displaced intra-articular calcaneal fracture(DIACF), obereve and compare the clinical curative effect of three kinds of operative methods. In order to explore which method of treatment of calcaneal fractures is more reasonable,for clinical doctor to treat calcaeal fractures proide more scientific plan,as far as possible,improve the patients quality of life after surgery.Methods: Between July 2005 and April 2015, Sixty-five patients with Seventy-four fracture of the calcaneus with closed, displaced intra-articular calcaneal fracture(DIACF) were included in the study after thorough clinical and radiological examination, were available for follow-up, and were divided into three groups for comparison. Group A consisted of 20 patients(24 fractures) who were using methods of percutaneously introduced Steinmann ′ s pins, Group B was composed of 19patients(22 fractures) who were using methods of Open Reduction and Internal Plate Fixation(ORIF) with nonlocking compressive plate, Group C was composed of 26patients(28 fractures) who were using methods of ORIF with locking compressive plate.Each patient was contacted to complete a follow-up survey from which the Maryland Foot Score(MFS)(maximum 100, higher scores indicate better outcome) outcome scores were calculated and recorded. Before 、 after surgery of the Calcaneal height, calcaneal width, Bohler ′ s angle and Gissane ′s angle change was recorded in each patient.Allthe included patients were followed up to average 40.28 month.Results:1 Three groups of cases there was no statistically significant difference in age, sex(P > 0.05). Three groups were comparable.2.Three methods of treatment can effectively restore and keep the Calcaneal shape,MFS score differences between three groups have no statistical significance.3.Before the operation,Compared with group A, patients of B and C with more loss of Calcaneal height,better recovery of Gissane ′s angle and calcaneal width, longer time in the hospital, lower incidence of osteoarthritis,lower incidence of traumatic arthritis. The comparison of all items between the B and C groups without difference.Conclusion:1.Intra-articular calcaneal fractures can be effectively treated by each operative methods.2.A group of patients before surgery collapse is light, poor shape recovery after the surgery, the incidence of traumatic sex arthritis is high. Open reduction and internal fixation has advantages in the treatment.3.For open reduction technology, different of the internal fixation material does not affect the treatment effect.