Open Reduction and Internal Fixation+Clinical Analysis of the Bone Graft Treatment Sandersiii Calcaneal Fractures
|School||Nanjing University of Traditional Chinese Medicine|
|Keywords||SandersⅢtype calcaneal fractures Open reduction and internal fixation Allogeneic bone Bone graft|
Objective: To calcaneal fracture of Sanders classification type Ⅲ patients underwent open reduction and AO calcaneal plate internal fixation and bone grafting, and clinical efficacy, sum up experience and improve the therapeutic effect, minimizing the incidence of complications and improve patient functionthe recovery results provide a reference for the clinical treatment options.Methods:The study included25cases of Sanders, Ⅲ calcaneal fractures, all from the Jiangsu Provincial Hospital orthopedic wards will be divided into three groups:group A patients with a total of8cases of intraoperative graft material for autogenous iliac bone;nine cases of patients, intraoperative graft material for allogeneic bone; a total of eight cases of group C patients were not graft in treatment. Postoperative intravenous antibiotics and oral medicine and supportive treatment, follow-up of the patients foot function recovery, postoperative complications, calcaneus, and X-ray morphology, and were followed up for12-17months, with an average follow-up of14months and the data obtained SPSS19.0statistical software, processing and analysis based on statistical methods to infer different efficacy of the treatment program if there was significant difference.Results:All patients with postoperative wound healed, does not appear incision skin necrosis and other complications.1, after the three Maryland ratings:postoperative function score on the bone graft group (A, B) with and without bone graft group (C) significantly different (*P<0.05); group A, group B, the two groups compared significant difference (P>0.05).2fractures loss rate of bone graft group (A, B) with bone graft group (C) significantly different (*P<0.05); group A, group B, two groups showed no significant difference (P>0.05). Indicators3, X-ray after surgery and during follow-up of three groups:(1) postoperative:Bolher angle, Gissane angle, calcaneal width of calcaneal height of the three groups no significant difference (P>0.05);2after6months:bone graft group (A, B) and non-bone graft group (C) in Bolher angle, and calcaneal height were significantly different (*P<0.05) in Gissane angle and calcaneal width, no significant difference (P>0.05), group A, group B two sets of indicators compared to no significant differences (P>0.05);③year after surgery:bone graft group (A, B) with bone graft group (C) Bolher angle there is a significant difference (*P<0.05) and calcaneal height, in Gissane angle and calcaneal width, no significant difference (P>0.05), group A. group B two sets of indicators compared to no significant difference (P>0.05).4, after and during follow-up of each group within each x-ray index changes:(1) height:postoperative and follow-up period in group A, B, calcaneal height there was no significant change (P>0.05), Group C after surgery and postoperative6months compared to no significant change (P>0.05) after6months, one year after surgery compared with significantly different (*P<0.05);②width:width during the postoperative and follow-up group of the calcaneus no significant change (P>0.05); the③Bolher angle: Postoperative and follow-up period of group A and group B the two groups compared, no significant difference (P>0.05); C group after6months after surgery compared with no obvious change (P>0.05) after6months, one year after surgery compared to significantly different (*P<0.05);④The Gissane angle:during the postoperative and follow-up of three groups Gissane angle did not change significantly (P>0.05).Conclusion:1、incision reduction and AO plate fixation and bone graft of calcaneal SandersⅢ fractures can significantly improve recovery in patients after calcaneal height angle and Bolher the width of the right calcaneus angle Gissane the change had no obvious effect.2、cut reduction and AO plate fixation of calcaneal SandersⅢ fracture surgery, bone grafting can significantly improve the efficacy of a significant effect to improve the calcaneal height and the angle Bolher the loss of reduction in patients with weight-bearing situation.3. Risk control, allogeneic bone graft surgery, surgical trauma, the patients suffered less pain, and worthy of promotion in clinical practice.