The efficacy analysis of arthroscopic reduction combined with percutaneous screw technique in the treatment of Sanders type Ⅱ and type Ⅲ calcaneal fractures

doi:10.11958/20252115

Abstract

Abstract:

Objective To explore the efficacy of arthroscopic reduction combined with percutaneous screw fixation in the treatment of Sanders types Ⅱ and Ⅲ calcaneal fractures. Methods Forty-eight patients with Sanders types Ⅱ and Ⅲ calcaneal fractures were divided into the arthroscopic reduction combined with percutaneous screw fixation (arthroscopy) group (n=23) and the tarsal sinus approach open reduction combined with screw internal fixation (tarsal sinus approach) group (n=25) according to different surgical methods and plans. The operative time, incision length, postoperative complications and secondary removal of internal fixation were compared between the two groups. Changes in B?hler’s angle and Gissane’s angle were evaluated and compared between the two groups at 3 months, 6 months after operation and at the last follow-up. Additionally, the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score and the visual analog scale (VAS) for pain were used to assess outcomes at the last follow-up. Results Compared with the tarsal sinus approach group, the incision length was reduced, the operation time was prolonged and the incidence of complications was decreased in the arthroscopic group (P<0.05). At 3 months, 6 months after the operation and the last follow-up, there were no significant differences in the B?hler Angle, Gissanes Angle, AOFAS and VAS scores between the arthroscopic group and the tarsal sinus approach group (P>0.05). Conclusion Both groups of regimens can enable patients to achieve good postoperative therapeutic efficacy. However, under arthroscopic assistance, surgical incisions inherently possess minimally invasive advantages, while the incidence of postoperative complications is lower compared to the sinus tarsi approach.

Key words: fracture, fracture fixation, arthroscopic examination, calcaneus, postoperative complications

CLC Number:

R687.3

Figures/Tables 7

References 19

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组别	n	性别（男/女)	年龄/ 岁	BMI/ （kg/m²）	致伤原因（高处坠落/车祸）
跗骨窦入路组	25	17/8	41.7±11.4	21.9±2.13	14/11
关节镜组	23	16/7	41.5±11.7	22.1±2.62	13/10
t或χ²		0.014	0.059	0.825	0.001
组别	受伤腿侧（左/右）		Sanders分型（Ⅱ型/Ⅲ型）		伤后至手术时间/d
跗骨窦入路组	16/9		16/9		4.0（4.0，5.0）
关节镜组	15/8		16/7		4.0（3.5，5.0）
Z或χ²	0.016		0.193		0.940

组别	n	性别（男/女)	年龄/ 岁	BMI/ （kg/m²）	致伤原因（高处坠落/车祸）
跗骨窦入路组	25	17/8	41.7±11.4	21.9±2.13	14/11
关节镜组	23	16/7	41.5±11.7	22.1±2.62	13/10
t或χ²		0.014	0.059	0.825	0.001
组别	受伤腿侧（左/右）		Sanders分型（Ⅱ型/Ⅲ型）		伤后至手术时间/d
跗骨窦入路组	16/9		16/9		4.0（4.0，5.0）
关节镜组	15/8		16/7		4.0（3.5，5.0）
Z或χ²	0.016		0.193		0.940

组别	n	切口长度/cm	手术时间/min	内固定二次取出情况		并发症
组别	n	切口长度/cm	手术时间/min	因附骨窦疼痛取出	要求取出	伤口延迟愈合	跗骨窦区疼痛	足背外侧麻木
跗骨窦入路组	25	4.99±0.80	72.06±8.52	6	3	0	6	2
关节镜组	23	1.24±0.17	87.65±6.48	1	3	0	1	0
t、χ²或P		22.916^＊＊	7.094^＊＊	2.304	0.000	0.024^▲

组别	n	切口长度/cm	手术时间/min	内固定二次取出情况		并发症
组别	n	切口长度/cm	手术时间/min	因附骨窦疼痛取出	要求取出	伤口延迟愈合	跗骨窦区疼痛	足背外侧麻木
跗骨窦入路组	25	4.99±0.80	72.06±8.52	6	3	0	6	2
关节镜组	23	1.24±0.17	87.65±6.48	1	3	0	1	0
t、χ²或P		22.916^＊＊	7.094^＊＊	2.304	0.000	0.024^▲

组别	n	B?hler角/°
组别	n	3个月	6个月	末次随访
跗骨窦入路组	25	28.2±3.5	26.9±4.1	25.9±5.8
关节镜组	23	27.4±3.1	26.3±4.5	24.4±5.7
t		0.840	0.481	0.904
组别	Gissanes角/°
组别	3个月		6个月	末次随访
跗骨窦入路组	122.5±3.1		119.6±3.8	116.5±3.7
关节镜组	121.2±2.9		118.2±3.0	115.2±3.6
t	1.501		1.423	1.233