Observation On The Effect Of Treating Calcaneal Fracture With Tarsal Sinus Incision Combined With Herbal Fumigation

Objective: To observe the curative effect of open reduction and internal fixation of tarsal sinus incision on Sanders type II and III calcaneal fracture,and to explore the clinical effect of fumigation and washing with Chinese herbs on pain and function after calcaneal fracture operation.Methods: 43 effective cases were collected,and all patients were followed up for 11-15 months,including 10 females and 33 males,aged 20-59 years,with an average age of(40.60±10.67)years.Sanders type ? 25 cases,Sanders type ? 18 cases,all patients underwent open reduction and internal fixation of tarsal sinus incision,preoperative and postoperative 1day,6 month after operation measure calcaneal Bohler Angle and Gissane Angle,were analyzed retrospectively.Postoperative patients were randomized into the observation group(21 cases)and the control group(22 cases),all of which were instructed in functional exercise.The observation group was treated with fumigation with traditional Chinese medicine at 3weeks after surgery,and the control group was treated with fumigation with warm water.The VAS scores of postoperative foot pain at 5,7 and 9 weeks and the AOFAS scores of the two groups at 6 months after surgery were recorded.Results: Statistical analysis of the observation results with SPSS23.0 statistical software showed that:1.Bohler Angle and Gissane Angle were measured and compared preoperatively and 1day after surgery,and the difference in Angle between preoperatively and 1 day after surgery was statistically significant(P <0.05).Bohler Angle and Gissane Angle were measured andcompared 1 day after surgery and 6 months after surgery,and the difference in Angle between1 day after surgery and 6 months after surgery was not statistically significant(P >0.05).2.There were statistically significant differences in pain scores between the two groups at5,7 and 9 weeks after surgery(P <0.05).Excellent results of VAS score after treatment:excellent in 6 cases,good in 14 cases,fair in 1 case,poor in 0 cases,excellent and good rate of 95.24% in the observation group;The control group was excellent in 1 case,good in 17 cases,acceptable in 4 cases,and poor in 0 cases,with an excellent and good rate of 81.82%,and the difference was statistically significant(P <0.05).3.Follow-up AOFAS score at 6 months after surgery: the average score(82.76±6.40)in the observation group was excellent in 4 cases,good in 15 cases,fair in 2 cases and poor in0 cases,with an excellent and good rate of 90.48%.The average score of the control group(78.36±5.97)was 0 for excellent,17 for good,5 for fair,and 0 for poor,with an excellent and good rate of 77.27%.The difference between the two groups was statistically significant(P <0.05).Conclusions: 1.Sanders type II and III calcaneal fractures treated with minimally invasive internal fixation through tarsal sinus incision can restore the normal anatomical angle of calcaneal Bohler angle and Gissane angle,and form a firm and stable fixation to prevent angle loss.It is an optional surgical incision for Sanders type II and III calcaneal fractures.2.After calcaneal fracture operation,minimally invasive incision is helpful for early functional exercise of affected foot,and combined with fumigation and washing of traditional Chinese medicine,it has obvious clinical effect on alleviating chronic pain after hind foot operation and restoring foot function.It is a method worthy of clinical promotion.