Effects of Wuwei-Xiaodu Decoction on limb swelling and fracture healing in intra-articular calcaneal fractures after open reduction and internal fixation / 国际中医中药杂志

ABSTRACT

Objective:To investigate the effect of Wuwei-Xiaodu Decoction in treating intra-articular calcaneal fractures after open reduction and internal fixation and its effect on hemodynamics. Methods:A total of 88 intra-articular calcaneal fractures patients admitted to Langfang People's Hospital and the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from April of 2016 to February of 2019 were selected and randomly divided into the control group and the observation group (44 patients in each group) by the method of random number table. Both groups received open reduction and internal fixation for intra-articular calcaneal fractures. The control group received conventional treatment after surgery. The observation group were treated with Wuwei-Xiaodu Decoction on the basis of treatment in the control group. Both groups were treated for 12 weeks. The Gissane Angle, Bohler Angle and calcaneal height were detected by X-ray and CT. The hemodynamic analyzer was used to determine ESR, Fibrinogen (Fb), and whole blood viscosity. The recovery of foot function was evaluated by using the Ankle-posterior foot scoring system of the American Orthopaedic Association, and the fracture healing time and complications were recorded. Results:After treatment, the Gissane Angle (130.01°± 15.76° vs. 121.33°± 14.33°, t=2.793), Bohler Angle (33.04°± 5.03° vs. 28.93°± 4.31°, t=4.189) and calcaneal height (44.13 ± 6.13 mm vs. 40.06 ± 5.87 mm, t=6.556) in the observation group were significantly higher than those in the control group ( P<0.01). The fracture healing time (66.85 ± 8.17 d vs. 78.04 ± 9.44 d, t=5.945) in the observation group was significantly lower than that of the control group ( P<0.01). After treatment, serum ESR (13.65 ± 1.94 mm/h vs. 18.99 ± 2.30 mm/h, t=11.772), Fb (301.83 ± 32.04 g/L vs. 319.85 ± 33.62 g/L, t=2.536) levels and whole blood viscosity (7.04 ± 0.82 mPa?s vs. 8.34 ± 0.92 mPa?s, t=6.997) in the observation group were significantly lower than those in the control group ( P<0.01). The effective rate of foot function recovery 6 months after operation in the observation group was 97.7% (43/44) and 81.8% (36/44) in the control group, and the difference between the two groups was statistically significant ( χ2=4.456, P=0.035). The complication rate was 4.6% (2/44) in the observation group and 20.5% (9/44) in the control group, and the difference between the two groups was statistically significant ( χ2=5.091, P=0.024). Conclusions:The Wuwei-Xiaodu Decoction can promote the recovery of bone shape after open reduction and internal fixation of intra-articular calcaneal fractures, reduce the complications after operation, promote fracture healing, and improve the hemodynamics.