Comparison of Ilizarov technique and open reduction with internal fixation in treatment of calcaneal fracture / 中华骨科杂志

ABSTRACT

Objective To compare the clinical effect of the treatment for calcaneal fracture by percutaneous reduction combined with Ilizarov stent and open reduction and internal fixation.Methods Data of 35 patients with closed calcaneal fractures from June 2012 to January 2014 were respectively analyzed.13 cases were fixed with poking reduction and Ilizarov support.Among them,there were 9 males and 4 females,aging from 20 to 51 years old (average,34.46± 10.21 years);Sanders type Ⅱ fractures in 2,type Ⅲ in 8 and type ⅣV in 3;Tscheme-Gotzen 2 degree of soft tissue injury in 9 and 3 degree in 4.22 cases were treated with open reduction and internal fixation.Among them,there were 15 males and 7 females,aging from 18 to 60 years old (average,33.59±12.07 years);Sanders type Ⅱ fractures in 3,type Ⅲ in 15,type ⅣV in 4;Tscheme-Gotzen 0 degree of soft tissue injury in 13 and 1 degree in 9.Results There was no significant difference in the anatomic parameters between the two groups before operation.Postoperative calcaneal B(o)hler angle of stent group (27.77°±2.86°) was less than that of the plate group (30.45°±3.45°),and Gissane angle of stent group (131.23°±3.92°) was larger than that of the plate group (127.82°±4.65°);axis angle of stent group (19.23°±2.20°) was less than that of the plate group (22.64°±5.14°);calcaneal width of stent group (33.61±3.43 mm) was less than plate group (36.05±3.26 mm),and the difference have statistical significance.The calcaneal length of the stent group (63.23±5.67 mm) was smaller than that in the plate group (63.59±4.58 mm),but there was no significant difference.The time from the injury to surgery in stent group (4.77±0.83 d) was less than that in the plate group (6.68± 1.84 d),the blood loss of stent group (45.00±6.04 ml) was significantly less than that of the plate group (292.95±43.66 ml).The fracture healing time of stent group (9.31± 1.38 week)was less than that of the steel plate group (9.82± 1.40 week),but there was no significant difference.About limb function American Orthopaedic Foot and Ankle Society (AOFAS) score,7 cases in the stent group were excellent,3 cases good,1 cases fair,2 cases poor;and 9 cases of the plate group were excellent,7 cases good,3 cases fair,3 cases poor,there was no significant difference.Conclusion For the Sanders Ⅱ / Ⅲ type calcaneal fractures and Sanders type ⅣV patients associated with soft tissue damage which are not suitable for open reduction and internal fixation in short term,Ilizarov technique is a good option.