Comparison And Analysis Of Locking Plate External Fixation And Internal Fixation In Treatment Of Sanders Ⅱ、Ⅲ Type Calcaneal Fractures

Objective: To compare the clinical efficacy between Locking plate external fixation and Open reduction plate fixation in the treatment of type SandersII,III calcaneal fractures after percutaneus joystick reduction by Minimally invasive method, to explore further the advantages and disadvantages between the two kinds of operation method.Method: 50 cases of unilateral and fresh calcaneal fractures from Feb.2012 to Mar.2013 were divided into two groups: group treated by locking plate external fixation after percutaneus joystick reduction(Percutaneous external fixation group,25 cases) and group treated by open reduction and internal fixation(Percutaneous internal fixation group,25 cases). To compare the two groups of patients with relevant index: time of operation, intraoperative blood loss, Incision healing time, length of hospital stays, Radiographic parameters before, after operation and in the final follow-up, postoperative complications and the codition of foot functional recovery(evaluated by Maryland score).Then the various data observed were analyzed statistically. Taking a=0.05 as the inspective level. P<0.05 means significant differences.Results: 50 cases of patients were followed for 6-12 months, the average time was 9 months. Significant difference could be found in time of operation, intraoperative blood loss, Incision healing time, length of hospital stays between the two groups(P<0.05). The Bolher angle, Gissane angle, the width of the calcaneus and the recovery of the foot function were not statistically significant between two groups(P>0.05). The imaging parameters of the two groups were significantly improved compared with that before the operation(P<0.05). The final follow-up imaging parameters of the two groups were not significantly lost(P>0.05) after the surgery. The fracture healing, skin necrosis, infection cases had not appear in the Percutaneous external fixation group. Traumatic arthritis of subtalar joint happened in only one case. There was four cases of wound skin infection, one case of gastrocnemius neuritis, one case of Traumatic arthritis of subtalar joint in the Percutaneous internal fixation group. The foot function score and excellent rate in Percutaneous internal fixation group is slightly higher than the other group, but the difference was not statistically significant(P>0.05). The incidence of complications between the 2 groups was statistically significant(P<0.05).Conlusion: Locking plate external fixation in treatment of type SandersII, III calcaneal fractures after percutaneus joystick reduction by Minimally invasive method could result in equally good reduction and reliable fixation. the intraoperative bleeding and postoperative complications were less. No obvious losses of forward calcaneal imaging parameters were found. The operation time, the healing time and the hospital stay were shorter. This kind of operation method is thought to be a reliable, effective and practical operation method.