Comparison Of Operative And Nonoperative Treatment Of Sanders Type Ⅳ Calcaneal Fracture

Objective: To investigate the clinical effect of surgical and non-surgical treatment of Sanders type IV calcaneal fracture.Methods: This study retrospectively analyzed 56 patients(63 feet)with Sanders type IV calcaneal fracture admitted to hospital from January 2014 to January2019.In the operation group,37 patients(41 feet)were aged 19-58 years,the average age :(38.32±9.27)years;All patients in this group received ORIF.In the non-operation group,19 patients(22 feet)were aged 23-58 years,with an average of(41.77±8.52)years;All patients in this group were treated with nonoperative treatment.Bohler Angle,Gissane Angle,calcaneal height,calcaneal width,chronic pain,subtalar arthritis,time to return to work,average length of hospital stay,etc,were collected and compared between the two groups before and after treatment.The AOFAS Foot and Posterior Ankle Scale was used for evaluation.Results: Patients in both groups were followed up for 1.6 to 5.8 years,with an average of 3.45 years.The ankle function of the two groups was evaluated according to the AOFAS score at the last follow-up.In the ORIF group,excellent: 4 cases,good :24 cases,fair:11 cases,poor:2 cases.The excellent and good rate was 68.3%,with an average of 77.34±10.37 points.In the non-operative treatment group,excellent: 2cases,good : 7 cases,fair:11 cases,poor:2 cases.The excellent and good rate was40.9%,and the average score was 71.05±12.12.The curative effect of the operative treatment group was better than that of the non-operative treatment group(P<0.05).Surgical treatment could significantly improve Bohler angle and Gissane angle compared with non-surgical treatment.There were no significant differences in height,width,chronic pain,subtalar arthritis and time to return to work between 2groups(P>0.05).Conclusion: Open reduction plate internal fixation can better restore calcaneus anatomical morphology,significantly improve the long-term clinical efficacy of patients;Manifold reduction and plaster external fixation can provide early functional exercise and avoid complications of surgical incision.