Lateral bone flap approach compared to traditional lateral L-shaped approach for Sanders Ⅲ-Ⅳ type calcaneal fractures

CHEN Chao; CHEN Geng; QIAN Zeng-jie; ZHANG Chang-hong; WEN Liang; YAN Qiang; XU Chang-bing

doi:10.3969/j.issn.1009-4237.2017.10.013

Abstract：Objective To compare wound complications,clinical function and radiographic results between lateral bone flap approach and traditional lateral l-shaped approach for sanders Ⅲ-Ⅳ type calcaneal fractures. Methods A total of 46 patients were treated by open reduction and internal fixation between Feb. 2013 to Feb. 2015. These patients were divided to bone flap approach group (lateral bone flap approch for fracture,n=23) and traditional approach group ( traditional lateral L-shaped approach for fracture, n =23 ) according to different ap-proach. Data was compared between the two groups,including length of hospital stay,wound complications,time of fracture union,clinical function,width of the calcaneal,Bohler's angle,and Gissane's angle. Results All of 46 pa-tients were followed up,and the mean follow-up in bone flap approach group and traditional approach group was 24. 7 (12-36) months and 22. 3(12-36) months,respectively. There was no significant difference in follow-up time be-tween two groups ( P>0. 05 ) . There was 1 ( 4. 3％) patient with wound complication ( superficial infection ) in bone flap approach group,and 8 (34. 7％) patients with wound complication (4 patients with skin flap necrosis,2 with incision dehiscence and 2 with superficial infection) in traditional approach group. There was significant differ-ence in rate of wound complication between two groups (P<0. 05). However,there was no significant difference be-tween two groups in term of the length of hospital stay,time of fracture union,clinical function,width of the calcane-al,B?hler's angle,and Gissane's angle (P>0. 05). Conclusion Both bone flap approach and traditional approach for the Sanders Ⅲ-Ⅳ Type calcaneal fractures can achieve satisfactory clinical function and radiographic results,but the bone flap approach has the advantage of low wound complication rate.