Case-control study on poking closed reduction cannulated screw fixation and small incision reduction plate fixation for the treatment of calcaneal fractures / 中国骨伤

ABSTRACT

OBJECTIVE@#To compare poking closed reduction cannulated screw fixation and small incision reduction plate fixation in treating calcaneal fractures.@*METHODS@#Clinical data of 98 patients with calcaneal fractures were retrospectively analyzed from June 2015 and June 2018. According to fracture classification and treatment methods, the patients were divided into poking closed reduction cannulated screw fixation (group A) and small incision reduction plate fixation(group B). In group A, there were 50 patients, including 32 males and 18 females with an average of (32.6±6.7) years old; 30 patients were classified to type Sanders II-III and 20 patients were type Sanders IV; treated with poking closed reduction cannulated screw fixation. While in group B, there were 48 patients, including 30 males and 18 females with an average of (31.9±7.2) years old; 28 patients were classified to type Sanders II-III and 20 patients were type Sanders IV; treated with small incision reduction plate fixation. Böhler angle, Gissane angle and AOFAS scores were compared between two groups before operation and 1 month, 1 year after operation.@*RESULTS@#All patients were followed up for 13 to 24 months with an average of (14.6±6.3) months. Böhler angle, Gissane angles and AOFAS score between two groups were improved at different degrees after operation. For Sanders II and III patients, there were no statistical differences in Böhler angle, Gissane angle between two groups before operation, 1 month and 1 year after operation; and there was no differences in AOFAS score between two groups at 1 year after operation. For Sanders IV patients, Böhler angle [(35.40±1.85)°, (35.15±1.90)°] and Gissane angles[(127.80±5.49)°, (127.00±3.06)°] in group B were higher than that of group A[(27.85±3.42) °, (27.25±1.80)° and (118.00±4.13)°, (117.50±5.04)°] at 1 month and 1 year after operation(<0.05); Böhler angle and Gissane angle at 1 month and 1 year after operation between two groups were improved higher than before operation(<0.05); AOFAS score in group B (91.00±5.46) was higher than that of group A (84.50±4.64) (<0.05).@*CONCLUSIONS@#For Sanders II-III calcaneal fractures, the two treatment methods have the equivalent effect. While for Sanders IV patients, small incision reduction plate fixation has better reduction, stable fixation and could improve foot function compared with poking closed reduction cannulated screw fixation.