Comparison Of Therapeutic Effects Of Tarsal Sinus Incision And Lateral "L" Incision Used In The Surgical Treatment For SandersⅢ Type Fracture

Objective:To analyze and compare with the two schemes,the lateral ’L’ type incision treatment and tarsal sinus incision treatment used in the surgical treatment for Sanders typelll fracture,in hoping to provide support for choosing reasonable scheme for the treatment of calcaneal fracture.Method:The medical data of calcaneal fracture treated by tarsal sinus incision(minimally invasive group,11 cases)and lateral "L" incision(traditional group,26 cases)open reduction and plate internal fixation at our hospital between August,2014 and October,2018 were selected for the retrospective analysis.The patients’ gender,age,hospital stay,preoperative waiting duration,intraoperative duration,treatment expense,Gissane angle(preoperative,intraoperative,postoperative and follow-up data),Bohler angle(preoperative,intraoperative,postoperative and follow-up data)in both groups were compared,statistical analysis was done,and the patients’postoperative or in-hospital incision complications were compared at the same time.VAS evaluation was done on each patient every day at the first three postoperative days;the foot function in the last follow-up was evaluated via AOFAS grading system,and the excellent rate was calculated.Result:All of the 26 cases of patients obtained follow-up lasting between 10-20 months,through follow-up and statistical results analysis,the observational indexes and conclusions with statistical differences between two groups of objects in this study are as follows:the hospital stay(11.00±2.48)days,surgical expense(10104.47±1189.09)RMB and incision coincidence(0.00%)in the minimally invasive group was superior to the hospital stay(14.73±2.89)days,surgical expense(16288.14 ±1013.90)RMB and incision coincidence(26.66%)in the traditional group,the difference had statistical significance(P<0.05).The surgical duration(93.45±2.84)min of minimally invasion group was longer than that of traditional group(84.20±2.71)min,the difference had statistical significance(P<0.05).After the surgery,both surgical methods could regain the Bohler angle and Gissane angle into the normal range;while the differences among preoperative waiting duration,Gissane angle,Bohler angle,VAS and AOFAS grading between two groups had no statistical significance(P>0.05).Complications such as incision cracking,not-healed fracture,incision marginal necrosis and infection etc.were not occurred to the patients in the minimally invasive group,while there were 4 cases of incision complications and one case of traumatic arthritis in the traditional group.Conclusion:Two types of therapy in this study are effective treatment methods,both Gissane angle and Bohler angle could normally regain to the ideal state,the patient,s postoperative and follow-up VAS grading,AOFAS grading and the excellent rate are relatively ideal.The tarsal sinus incision for the treatment of calcaneal fractures,through comparative study,can achieve satisfactory effect;besides,the tarsal sinus approach has merits such as minimal invasion,short hospitalization period,less cost and fewer complications etc.Therefore,minimal invasion surgery such as tarsal sinus approach applied in the treatment of calcaneus fracture is much more worth popularizing in the future clinic after experienced grasp of surgical skills.