| ObjectiveThe purpose of this study was to explore the clinical therapeutic effect of manipulation combined with small tarsal sinus incision assisted reduction and external fixator fixation in the treatment of closed calcaneal fractures,and whether it is more advantageous than the traditional lateral 1-type open reduction plate internal fixation.MethodsA total of 60 patients with closed calcaneal fracture who met the inclusion criteria and diagnostic criteria of the study were randomly divided into control group and experimental group with 30 patients in each group,including 34 patients with left foot,26 patients with right foot,50 males and 10 females.Sanders ? 24 cases,Sanders ? 27 cases,Sanders ?type 9 cases.In the control group,the calcaneal fractures were treated with 1-shaped incision open reduction and internal fixation with steel plate.The experimental group was treated with calcaneal fracture manipulation combined with external fixator fixation with small incision of tarsal sinus.Observation indicators:(1)operative data:operation time,intraoperative blood loss,injury to operation time,hospital stay,postoperative complications.Anatomical parameters of the affected calcaneus(preoperative and postoperative):Bohler Angle,Gissane Angle,heel length,width and height.(3 months after surgery):Maryland foot score.Results1.Before treatment,there were no statistically significant differences in gender,age,disease course,Sanders classification,and anatomical parameters of calcaneus on the affected side between the two groups(P>0.05),which was of comparative research value.2.After treatment,the operative time,intraoperative blood loss,length of stay and postoperative complications were all lower in the experimental group than in the control group,with statistically significant differences(P<0.05).3.In the postoperative group,Bohler Angle,Gissane Angle,heel length and height were all greater than those before surgery,and the width was smaller than those before surgery,and the differences were statistically significant.Postoperatively,the calcaneus Bohler Angle test group(27.44°±5.29°)was similar to the control group(26.50°±4.70°),the Gissane Angle test group(130.05°±4.96°)was similar to the control group(130.45°±4.26°),the heel length test group(7.92±0.54 cm)was similar to the control group(7.84±0.45 cm),and the heel width test group(4.02±0.46 mm)was similar to the control group(3.93±0.51 mm).The external fixator group of heel height[(4.61±0.35)cm]was similar to the steel plate group[(4.60±0.37)cm],and there was no statistically significant difference between the above indexes.4.Postoperative Maryland foot score of the two groups was 39-98 points in the experimental group,among which 16 cases were excellent,10 cases were good,3 cases were ok,and 1 case was poor.The excellent and good rate was 86.7%(26/30).The control group was 33-97 points,among which 15 cases were excellent,9 cases were good,4 cases were ok,and 2 cases were poor.The excellent and good rate was 80%(24/30).The good and good rate of the experimental group was slightly higher than that of the control group,with no statistically significant difference(P>0.05).ConclusionManual combined tarsal sinus assisted small incision reduction and external fixator fixation group can get with open reduction and plate fixation is more close to the clinical treatment effect,and can reduce the trauma to patients,reduce the complications and avoid secondary operation,to reduce the advantages of the hospitalization expenses,conducive to the postoperative recovery of patients,worthy of clinical popularization and application. |
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