Treatment of calcaneal fracture with calcaneal reduction forceps and external fixation / 中国医师进修杂志

ABSTRACT

Objective:To study the clinical effect of the minimally invasive treatment of calcaneal fractures by closed reduction using calcaneal plastic reduction forceps combined with threaded-pin external fixation.Methods:Clinical data of 16 patients with unilateral calcaneal fractures admitted to Affiliated Zhongshan Hospital of Dalian University from January 2015 to December 2017, including 14 males and 2 females, with a unilateral calcaneal fracture were analyzed retrospectively. The Bohler angle, Gissane angle, and calcaneal width, height and length were measured before and after the operation. The ankle function was evaluated according to the AOFAS score at 6 and 12 months after the operation.Results:The Bohler angle, Gissane angle, width, height and length 3 d and 6 months after operation were significantly better than before operation (28.82 ± 1.72)° and (25.84 ± 1.96)° vs. (16.71 ± 2.74)°, (120.92 ± 3.85)° and (119.65 ± 3.84)° vs. (103.63 ± 4.62)°, (35.23 ± 1.94) and (36.51 ± 2.01) mm vs. (39.52 ± 1.26) mm, (48.52 ± 2.16) and (48.86 ± 1.98) mm vs. (46.94 ± 2.48) mm, (71.23 ± 2.49) and (70.94 ± 2.36) mm vs. (67.53 ± 2.53) mm, there were statistical differences ( P<0.05); there were no statistical difference in those indexes before 6 months after operation and 3 d after operation ( P>0.05). The average AOFAS score 12 months after operation was significantly higher than 6 months after operation (80.6 scores vs. 60.1 scores), there was statistical difference ( P<0.01). At the final follow-up, the AOFAS score was excellent, good, moderate, and poor in 11 cases, 3 cases, 1 case and 1 case. The average AOFAS score was 60.1 at 6 months after the operation and 80.6 at 12 months after the operation, which was significantly higher than the average AOFAS score at 6 months after the operation ( P < 0.01). At the final follow-up, the AOFAS score was excellent, good, moderate, and poor in 11 cases, 3 cases, 1 case and 1 case, respectively. Conclusions:The application of closed reduction using calcaneal plastic reduction forceps combined with threaded-pin external fixation is effective for the treatment of displaced calcaneal fractures, with a simple procedure, minimal trauma, fewer skin and soft tissue complications, and satisfactory clinical results.