ABSTRACT
BACKGROUND: Open reduction internal fixation and external fixation are two main surgical treatments for comminuted cuboid fractures. With the development of internal fixation devices, especially the appearance of mini-locking plate, the therapeutic effect of internal fixation has been improved. OBJECTIVE: To compare the clinical and imaging effects of mini-locking plate and external fixator in the treatment of comminuted cuboid fracture. METHODS: The data of 43 patients with comminuted cuboid fracture admitted to the Department of Orthopedics, Tianjin Port Hospital from January 2013 to March 2018 were retrospectively analyzed. According to different treatment methods, the patients were divided into two groups: 23 cases in the mini-locking plate group and 20 cases in the external fixator group. All patients signed the informed consent This study was approved by the Hospital Ethics Committee. The patients in both groups were confirmed as comminuted cuboid fracture by CT and three-dimensional reconstruction scan before operation. Bone graft support of allograft was performed during the operation, and the external fixator was removed within 3-4 months after operation. At the last follow-up, bilateral standing and anteroposterior and lateral X-ray examination was performed to compare the loss of height, length, width, lateral longitudinal arch angle, calcaneal fifth metatarsal angle, Maryland loot score, American Orthopedic Foot and Ankle Society Score and the incidence of complications between the two groups. RESULTS AND CONCLUSION: (1) All patients were followed up for more than one year. (2) There were no significant differences in height loss of cuboid bone, width loss, last lateral longitudinal arch angle, and calcaneal fifth metatarsal angle between the two groups (P > 0.05). (3) There were significant differences in the loss of cuboid bone length, Maryland foot score and American Orthopedic Foot and Ankle Society Score and the incidence of complications between the two groups (P < 0.05). Mini-locking plate group was superior to the external fixator group in above indexes. (4) These findings indicated that mini-locking piate and external fixator are effective methods for the treatment of comminuted cuboid fracture. Micro-locking plate has more advantages in maintaining the length of cuboid bone, clinical function and reducing complications. With the prolongation of time, stable foot and good function can be achieved.