[Case control study on the application of artificial bone and autogenous bone in internal fixation of complex calcaneal fracture with special-shaped plate].

OBJECTIVE: To compare clinical effects of artificial bone and autogenous bone in internal fixation of complex calcaneal fracture with profitated plate. METHODS: From April 2015 to April 2019, 60 patients with complex calcaneal fractures were treated with open reduction and heteromorphic plate internal fixation, and were divided into experiment group and control group by implant bone substitutes, and 30 patients in each group. In experiment group, there were 21 males and 9 females aged from 18 to 71 years old with an average of (36.85±7.42) years old;19 patients were classified to type Ⅲ and 11 patients were type Ⅳ according to Sanders classification;implanted with artificial bone. While in control group, there were 23 males and 7 females aged from 20 to69 years old with an average of (37.26±7.38) years old;18 patients were classified to type Ⅲ and 12 patients were type Ⅳ according to Sanders classification; implanted with autogenous bone. Operation time, intraoperative blood loss, drying time of incision, fracture healing time and complications were compared between two groups, changes of preoperative and postoperative Böhler angle and Gissane angle were also compared, and Maryland scoring was applied to evaluate recovery of affected foot. RESULTS: Both of two groups were followed up from 3 to 15 months with an average of (10.15±2.67) months. Operation time and intraoperative blood loss in experiment group were (89.32±12.43) min, (101.64±5.13) ml, respectively;while in control group were (112.45±13.82) min, (119.01±5.26) ml, respectively;and there were statistical difference between two groups (P<0.05). There were no differences in drying time of incision, fracture healing time and complications between two groups(P>0.05). Preoperative and postoperative Böhler angle at 3 months in experiment group were (14.19± 2.47)°, (34.52±4.41)°;while in control group were (14.08±2.35)°, (33.67±4.36)°;preoperative and postoperative Gissane angel at 3 months in experiment group were (90.16±6.43)°, (131.45±9.83)°;while in control group were (90.11±6.37)°, (130.87±9.24)°;there were statistical significance in Böhler angle and Gissane angel compared with 3 months after operation and before operation between two groups (P<0.05);while no difference at 3 months after operation between two groups (P> 0.05). There were no statistical meaning in Maryland items, total score and good rate between two groups at the final following up (P>0.05). CONCLUSION: Artificial bone and autogenous bone in internal fixation of complex calcaneal fracture with irregular plate have similar function in promoting fracture healing, drying time of incision, fracture healing time and complications, while artificial bone has better effects in reducing intraoperative blood loss, shorten operation time.

[Bone setting manipulation combined with surgery for the treatment of calcaneal fractures].

OBJECTIVE: To investigate the clinical effects of bone setting manipulation on simplified operation and swelling reduction in treating calcaneal fractures. METHODS: From December 2005 to November 2010, 42 patients with calcaneal were reviewed, including 25 males and 17 females, ranging in age from 18 to 74 years, with an average of 41.4 years. Twenty patients had fractures in the left and 22 in the right. Twenty-three patients were treated with anatomical plate fixation, 19 patients were treated with Kirchners wires or cannulated screws fixation. The average period of swelling in soft tissue, joint function and complications were evaluated. RESULTS: Forty-two patients were followed up, and the duration ranged from 3 to 18 months, with a mean of 8.3 months. The pain was markedly relieved at the next day after reduction, and the swelling was relieved in 3 to 5 days. The operative was simplified and the average operative time was 90 minutes. The swelling was relieved in 4 to 7 days after the operation, and the necrosis of skin was not found. The average postoperatively Böhler angle was (31 +/- 3.2) degrees. Gissane angle was (112 +/- 5.3) degrees. Calcaneal width was (30.2 +/- 0.89) mm. According to Maryland foot function score system, 16 patients got an excellent result, 18 good, 6 fair and 2 bad. CONCLUSION: The operation is simplified, and skin complications decrease, as well as the detumescence period is shortened.