A comparative study of difference internal fixation methods for calcaneal fracture / 中国医师进修杂志

ABSTRACT

Objective To observe the therapeutic effect of titanium plate and Kirschner wire system for treatment of calcaneal fracture.Methods The data of 189 patients with calcaneal fracture treated with operation were retrospectively studied,of which 102 patients of calcaneal fracture were treated with titanium plate fixation (titanium plate group),87 patients were treated with Kirschner wire system (Kirschner wire group).The operative time,blood loss,postoperative complication,healing time,before and after treatment Bohler angle,Gissane angle and middle calcaneal width,and Maryland foot function score were observed.Results The patients of the 2 groups were observed with 12-36 (24.0 ± 9.5) months follow-up.The operative time and blood loss in Kirschner wire group were significantly lower than those in titanium plate group [(42.3 ± 12.5) min vs.(67.5 ± 23.1) min and (137.7 ± 42.8) ml vs.(245.0 ± 55.6) ml],there were statistical differences (P ＜ 0.05).The Bohler angle,Gissane angle and middle calcaneal width in the 2 groups after treatment were significantly better than those before treatment [titanium plate group(32.80 ± 6.35)° vs.(7.81 ± 8.75)°,(130.42 ±6.93)° vs.(175.80 ± 6.05)°,(30.77 ± 3.56) mm vs.(42.60 ±5.24) mm; Kirschner wire group(30.11 ±4.91)° vs.(9.54 ±8.90)°,(132.89 ±9.54)° vs.(173.11 ±9.05)°,(32.00 ± 4.18) mm vs.(42.78 ± 4.96) mm],there were statistical differences (P＜ 0.05).The excellent rate of Maryland foot function score after treatment in titanium plate group was significantly higher than that in Kirschner wire group [92.2％ (94/102) vs.81.6％ (71/87)],there was statistical difference (P ＜ 0.05).Therewere 6 cases appeared infection of incisional wound in titanium plate group,there was no complication in Kirschner wire group,there was statistical difference (P ＜ 0.05).Conclusions Titanium plate and Kirschner wire system are the commonly used methods in treatment of calcaneal fractures,each has its advantages and disadvantages,titanium plate has long time operation,much blood loss and prone to infection,but the excellent rate is higher.Also note that the incision location,restoration and reconstruction of calcaneal anatomy subtalar joint.