| Objective: This study intends to comparative analyze the curative effect of the small sinus tarsi incision and the expanding lateral L-shaped incision for treatment of Sanders type Ⅱ and Ⅲ calcaneal fractures,and further analyze the advantages and the disadvantages of minimally invasive treatment for calcaneal fractures,so as to optimize the surgical plan and achieve the best curative effect,and provide new ideals for treatment of calcaneal fractures.Methods: Prospective study was performed.Patients with calcaneal fractures who underwent surgery in the Department of Trauma and Orthopaedics,First Affiliated Hospital of Nanchang University form June 2015 to June 2018 were divided into the experimental group and the control group according to different surgical methods.In the experimental group,the patients underwent open reduction and internal fixation with the small sinus tarsi incision,and the patients in the control group underwent open reduction and internal fixation with the expanding lateral L-shaped incision.The general clinical data,the B?hler angles and the Gissane angles of calcaneus before and after surgery,as well as Maryland foot function scores at the last follow-up were recorded.The collected clinical data were statistically analyzed by using SPSS statistical software.The measurement data were expressed as mean ± standard deviation((?)±s),and the independent sample t-test was used for comparing the difference between the two groups,and the difference was statistically significant at P<0.05.The enumeration data were compared by using the Chi-square test or the Fisher exact test,and the difference between the two groups was statistically significant at P<0.05.Results: 20 patients in the experimental group and 19 patients in the control group.All patients were followed up for 6 to 30 months,with an average follow-up time of (12.23±6.69)months.These were no statistical significance between the two groups in terms of age,gender,time of injury to surgery,time of postoperative antibiotic use and time of hospitalization(P>0.05).At the last follow-up,the B?hler angles and the Gissane angles of calcaneus were both significantly improved compared with preoperative(P<0.05),but the difference between the two groups was not statistically significant(P>0.05).There was also no statistical significance between the two groups in terms of the Maryland foot function scores at the last follow-up(P>0.05).In terms of postoperative complication,there were both no complications such as osteomyelitis,bone nonunion,internal fixation loose or fracture,and articular surface collapse again in the two groups,but there was 1 case of partial necrosis of incision in the experimental group,and there were 2 cases of incision infection and 2 cases of partial poor healing of incision in the control group.All of the above 5 patients’ incision healed well by prolonging the time of antibiotic use and dressing change actively during hospitalization.There was no statistical significance in postoperative complication between the two groups(P>0.05),and it may be related to the larger error caused by the less sample size in this study.Conclusions: The small sinus tarsi incision for treatment of Sanders II and III of calcaneal fractures had the characteristics of small surgical trauma,less postoperative complication,reliable fixation and satisfied curative effect,was a minimally invasive,simple and safe surgical approach,thereby it was worthy to be promoted in primary hospital. |
