Curative effect of prying reduction and external fixator in treatment of comminuted calcaneal fractures
FANG Zhen-hua;Wang Jun-wen;LIU Guo-hui;XIONG Yuan;CHEN Xi;Department of Orthopaedics, Puai Hospital Affiliated to Tongji Medical College Huazhong University of Science and Technology;
Objective To investigate the effect of prying reduction and external fixator in the treatment of comminuted calcaneal fractures. Methods From January 2013 to June 2014, 48 patients(57 feet) with comminuted calcaneal fractures underwent prying reduction and external fixator. Results All 48 cases were followed up for 6 to18 months, the mean period was 12 months. Bohler Angle was-20.6°-23.3°(7.5 ±12.1)° preoperatively, and 24.6°-34.3°(27.5 ±7.3)° after removal of external fixator, Gissane Angle was 138.6°-167.3°(154.5±8.1)° preoperatively and 107.6°-144.3°(127.5±13.2)° after removal of external fixator; Bohler angle, angle of Gissane were much improved after operation, the difference was statistically significant(t =1.023, P =0.036; t =0.809, P =0.027). Evaluated according to the American society for ankle surgery(AOFAS)ankle and foot scoring system at the last follow-up: 71-96(81.65-5.23)points, 39 cases were excellent, 7 cases good, 2 cases fair. No nail infection occurred. There was no patient with Steinmann pin slipping or snapping, and there were six cases of traumatic after surgery, while the symptoms were significantly relieved after the treatment of non-steroidal anti-inflammatory drugs. Conclusion Prying reduction and external fixator in the treatment of comminuted calcaneal fractures can obtain satisfactory reduction, and can avoid traditional large incision wound infection and skin flap necrosis caused by the occurrence of serious complications. It is effective in the clinical treatment of comminuted calcaneal fractures.