Comparison of curative effects between minimally invasive double incision and lateral L-shaped incision in treatment of calcaneal fracture

doi:10.3877/cma.j.issn.1674-134X.2022.04.021

Abstract

Abstract:

Objective

To compare the clinical outcomes of minimally invasive double incision approach and external L-shaped approach with internal fixation for treatment of Sanders typeⅡand Ⅲ calcaneal fractures.

Methods

According to different incision approaches, sixty patients with calcaneal fractures of Sanders typeⅡand Ⅲ who were treated in Xinhui People’s Hospital between January 2014 and June 2019 were enrolled and divided into the minimally invasive group(minimally invasive double incision approach) and routine group(external L-shaped approach), 30 cases in each group. The t test was used to analyze the preoperative time, operation time, blood loss, fracture healing time, B?hler angle, Gissane angle and American Orthopedic Foot and Ankle Society (AOFAS) score of the two groups; chi-square test was used to analyze the types and the causes; Fisher exact test was used to compare the wound complications.

Results

All the patients were followed up for an average of (13±3) months. The preoperative time of minimally invasive group was shorter than that of routine group (t=-8.152, P<0.05); the operation time in the minimally invasive group was shorter than that in the conventional group (t=-8.473, P<0.05); the blood loss in the minimally invasive group was less than that in the conventional group (t=-4.582, P<0.05). Incision complications occurred in three cases (10.0%) in the minimally invasive group, which was lower than that in 12 cases (40.0%) in the conventional group (P=0.015). There was no statistically significant difference between the two groups in terms of fracture healing time, B?hler angle, Gissane angle or AOFAS score (all P>0.05).

Conclusion

The minimally invasive double incision approach with internal fixation for treatment of Sanders typeⅡand Ⅲ ca1canea1 fractures has lesser operation time, less intraoperative blood loss and fewer wound complications.

Key words: Calcaneus, Intra-articular fractures, Internal fixators, Minimally invasive surgical procedures

Jianping Zou, Huixi Li, Jinming Chen, Kaihua Liu, Jinyu Chen, Junhua Lin. Comparison of curative effects between minimally invasive double incision and lateral L-shaped incision in treatment of calcaneal fracture[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2022, 16(04): 507-511.

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Figures/Tables 4

References 11

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组别	例数	侧别(例)		性别(例)		年龄[岁，(±s)]	受伤原因(例)			Sanders分型(例)
组别	例数	单侧	双侧	男	女	年龄[岁，(±s)]	A	B	C	Ⅱ	Ⅲ
微创组	30	25	5	24	6	43±11	22	7	1	26	9
常规组	30	26	4	25	5	44±9	23	5	2	23	11
统计值		χ²<0.001		χ²＝0.111		t＝－0.529	χ²＝0.786			χ²＝0.369
P值		>0.05		>0.05		>0.05	>0.05			>0.05

组别	例数	侧别(例)		性别(例)		年龄[岁，(±s)]	受伤原因(例)			Sanders分型(例)
组别	例数	单侧	双侧	男	女	年龄[岁，(±s)]	A	B	C	Ⅱ	Ⅲ
微创组	30	25	5	24	6	43±11	22	7	1	26	9
常规组	30	26	4	25	5	44±9	23	5	2	23	11
统计值		χ²<0.001		χ²＝0.111		t＝－0.529	χ²＝0.786			χ²＝0.369
P值		>0.05		>0.05		>0.05	>0.05			>0.05

组别	例数	术前等待时间[d，(±s)]	手术时间[min，(±s)]	术中出血量[ml，(±s)]	并发症(例)
微创组	30	4.8±1.3	56.7±7.3	19.3±7.5	3
常规组	30	9.3±2.7	76.7±10.7	30.7±11.3	12
t值		－8.152	－8.473	－4.582
P值		<0.001	<0.001	<0.001	0.015^*

组别	例数	术前等待时间[d，(±s)]	手术时间[min，(±s)]	术中出血量[ml，(±s)]	并发症(例)
微创组	30	4.8±1.3	56.7±7.3	19.3±7.5	3
常规组	30	9.3±2.7	76.7±10.7	30.7±11.3	12
t值		－8.152	－8.473	－4.582
P值		<0.001	<0.001	<0.001	0.015^*

组别	足例数	Böhler角(°)	Gissane角(°)	AOFAS评分(分)	骨折愈合时间(周)
微创组	35	26.1±5.2	122.9±6.6	80.8±5.8	11.8±1.4
常规组	34	24.9±5.3	123.4±8.1	79.9±4.3	12.0±2.0
t值		0.932	－0.296	0.768	－0.485
P值		>0.05	>0.05	>0.05	>0.05

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