Comparison of the advantages and disadvantages of cannulated screw internal plate fixation via the tarsal sinus approach and the plate fixation via the extended leteral incision in the treatment of SandersⅡ,Ⅲcalcaneal fractures

ZHANG Yuan-song

doi:10.3969/j.issn.1009-4237.2016.11.008

Abstract：Objective To compare the advantages and disadvantages of cannulated screw internal fixation via the tarsal sinus approach and the plate fixation via the extended lateral incision in the treatment of SandersⅡ,Ⅲcalcaneal fractures.Methods A total of 80 cases of calcaneal fracture admitted in our hospital from Feb.2013 to Feb.2015 were selected as research subjects.They were randomly divided into two groups with 40 in each group. Both groups carried out routine checks,and then the control group was treated with expansion of the inner and outer-notch plate fixation,while the study group was treated with cannulated screw fixation via the tarsal sinus approach. The average operation time,blood loss,wound healing time,average hospital stay,intra-articular calcaneal fractures length,width,height,Bohler angle,Gissane angle before and after surgery,Maryland score after surgery,AOFAS score and SH-36 score, foot function recovery after surgery and postoperative complications of patients in the two groups were detected and recorded.And the results were compared.Results The average operation time,intraop-erative blood loss,incision healing time and the average length of hospital stay in the study group were(50.3 ±4.5) min,(15.8 ±2.3) mL,(4.3 ±1.3) d,(4.9 ±0.8) d, respectively,significantly lower than those in the control group,with the difference statistically significant(P<0.05).After surgery,various indexes of patients in the two groups were improved compared with those before,and the differences were statistically significant( P<0.05);the study group had a greater extent of change than the control group(P<0.05).Maryland score of patients of the two groups in terms of the function and pain,showed no statisti-cally significant difference(P>0.05),while AOFAS score and SH-36 score in the study group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).The total excellent and good rate in the study group was 75.0%,significantly higher than that of the control group(50.0%),and the difference was statistically significant ( P <0.05 ) .After surgery, the total complications rate of the study group (10%) was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Cannulated screw fixation via tarsal sinus approach in the treatment of calcaneal fractures can significantly shorten the operation time,wound healing time and hospitalization time,reduce intraoperative bleeding, help to reduce the incidence of postoperative complications and improve the postoperative foot function recovery rate and have better efficacy than the plate fixation via the extended lateral incision.It is worthy of promotion.