Comparison Of Results Between Sinus Tarsi Invasive And L Incision Approach In The Treatment Of Calcaneal Fracture

BackgroundTo compare the effects between sinus tarsi approach with cannulated screws and traditional L incision approach with plate for treatment of closed calcaneal fracture,in order to provide a scientific basis for minimally invasive treatment of calcaneal fractures.Method47 cases of calcaneal fracture patients,which were selected from medical records in the department of orthopedics and trauma of the second hospital of Shandong University from July 2014 to December 2016,were retrospectively analyzed.The patients were diagnosed as closed calcaneal fracture,belongs to Sanders ? or Sanders ?.The experimental group of 22 patients were treated with tarsal sinus incision and cannulated screw internal fixation.25 cases of the control group were treated with traditional L type incision and plate internal fixation.Before and after surgery,were measured datas about calcaneal angle(Bohler angle),calcaneal cross angle(Gissane angle),scalcaneal height and width,hospitalization time,operation time,bleeding volume,complications and evaluated foot function by Maryland Foot Score(MFS)of every case.Through statistical analysis,we compared advantages and disadvantages of the two kinds of surgical treatment method used in Sanders ? or ? calcaneal bone fractures,to provide scientific and rational basis for minimally invasive treatment of calcaneal fracturesResultWe followed up 47 cases for 6-13 months,average 10 months.The results showed that two kinds of surgical treatment of Sanders ? or ? calcaneal fractures can obtain satisfactory clinical efficacy.Under the Maryland Foot Score(MFS),the experimental group and the control group compared with no significant difference(p?0.854>0.05;p=0.902>0.05).In terms of image about anatomical perspective,comparative analysis of two groups of postoperative Bohler angle recovery(p=0.821>0.05),there was no significant difference,the recovery of Gissane angle has significant difference(p=0.004<0.05);and no significant difference between the two groups of calcaneal height and width recovery(p=0.457>0.05;p=0.174>0.05).There are different degrees of postoperative complications between the two groups(p<0.01),no complications occurred after surgery in the experimental group.The two groups had significant postoperative hospitalization time difference(p=0.001<0.01),the control group was shorter than the experimental group.The two group had no significant difference in operation time(p=0.987>0.05).There was significant difference between the two groups in intraoperative blood loss(p=0.001<0.01),and the intraoperative bleeding in the control group was significantly less than that in the experimental group.ConclusionBoth two kinds of surgical treatment of Sanders II or III calcaneal fractures can correct the basic anatomical parameters of calcaneus satisfied and better restore the foot function.The traditional L type incision plate internal fixation is a good method for the treatment of calcaneal fractures,and it can be used to restore the anatomic parameters of the calcaneus.But the tarsal sinus incision with cannulated screws has clear small surgical trauma,less bleeding,less complications,shorter hospitalization time etc.It also can correct the calcaneal anatomic parameters to normal range,and can be very good to restore the foot function.For Sanders II or III closed calcaneal fracture,the minimally invasive treatment of calcaneal fractures is worthy and reliable.