Comparison Of Clinical Efficacy Between Tarsal Sinus Approach And Extensile L Shape Approach For Calcaneal Fracture

Background: The calcaneus is the largest piece of the tarsal bone of the foot.It is easy to fracture in the fall injury,accounting for 60% of the tarsal bone injury.At present,the most commonly used surgical approach for calcaneal fracture is the extensile L shape approach.This approach fully incision the skin and soft tissue of the calcaneal surface,so that the fracture line and the affected articular surface can be completely exposed,and the anatomical structure of the calcaneus can be further reduced under direct vision.After direct reduction,the calcaneus was firmly fixed by steel plate,so as to restore the anatomical form of calcaneus and achieve the purpose of functional rehabilitation.However,the tarsal sinus approach is gradually used in clinic because of the large injury and high incidence of complications.Objective: Through follow-up and investigation of patients with past calcaneal fracture in trauma department of a third-class hospital in shenzhen city,to understand the postoperative recovery of patients with calcaneal fracture through different surgical approaches in this hospital,through a case-control study,The effects of STA and ELA surgical approaches on the prognosis of calcaneal fracture patients were compared.Methods: The medical records of calcaneal fracture patients treated in trauma orthopedics department of Shenzhen second people’s Hospital from September 2018 to September 2020 were reviewed and followed up.Results: The average operation time of the tarsal sinus approach group was longer than that of the extensile L shape approach group,in which the average operation time of the study group was 131.42 min,the average operation time of the control group was 86.13 min.P<0.05.The drainage volume of the tarsal sinus approach group was smaller than that of the extensile L shape approach,P<0.05.The total hospitalization time of the study group was shorter than that of the control group,the average total hospitalization time of the study group(12.64 d±2.937 d),the control group(15.00 d±4.673 d)P <0.05.There was no significant difference in drainage time after operation.Five cases of skin margin necrosis occurred in the extensile L shape approach group,and there was no postoperative adverse reaction in the tarsal sinus approach group.Conclusion: Compared with the extensile L shape approach,the tarsal sinus approach can effectively avoid the occurrence of skin margin necrosis and infection,and is more conducive to improving the clinical efficacy of patients.