Clinical Application of L - shaped Extended Lateral Approach and Sinus Tarsi Approach Respectively Combined with Arthroscope Assisted reduction and Internal Fixation in Sanders II and III Calcaneal Fracture Surgery
SHENG Wei, LIN Min
Huangshi Mining Bureau Hospital of Hubei Province, Hubei Huangshi 435000, China
Abstract：Objective: To investigate and compare the effects of L-shaped extended lateral approach and sinus tarsi approach respectively combined with arthroscope assisted reduction and internal fixation in the treatment of Sanders II and III calcaneal fractures. Methods: The data of 76 patients with Sanders II and III calcaneal fractures who underwent arthroscope assisted reduction and internal fixation in the hospital during the period from August 2014 to August 2016 were analyzed retrospectively. Patients treated by L-shaped extended lateral approach were included in the incision group (31 cases) while patients treated by sinus tarsi approach were included in the minimally invasive group (45 cases). The situation of surgery and the incidence of complications in the two groups were statistically analyzed. Changes in radiographic parameters were compared between the two groups. The recovery of foot function was evaluated with the ankle and hindfoot function scores in the American Orthopedic Foot Andankle Society (AOFAS) at 6 months after surgery. Results: There was no significant difference between the two groups in the surgical time, fracture healing time and the excellent and good rate of foot function recovery (P > 0.05). The intraoperative blood loss and postoperative drainage volume of the minimally invasive group were less than those of the control group, the time of waiting for surgery, length of incision and incision healing time were shorter than those of the incision group (P < 0.05). The Bohler's angle, calcaneal height and width were increased while the Gissane angle and shift distance of subtalar joint surface were decreased in the two groups at the end of follow-up (P < 0.05), without statistically significant differences between the two groups (P > 0.05). The incidence rates of incision related complications and fetlock joint stiffness in the incision group were significantly higher than those in the minimally invasive group (P < 0.05). Conclusion: Effects of the two approaches combined with arthroscope assisted reduction and internal fixation are similar in the treatment of Sanders II and III calcaneal fractures. Compared with L - shaped extended lateral approach, sinus tarsi approach can reduce surgical trauma and further reduce the incidence of postoperative complications.
盛伟, 林敏. L形外侧扩大入路与跗骨窦间隙入路分别联合关节镜辅助下复位内固定在SandersⅡ Ⅲ型跟骨骨折手术中的临床应用[J]. 河北医学, 2018, 24(7): 1161-1164.
SHENG Wei, LIN Min. Clinical Application of L - shaped Extended Lateral Approach and Sinus Tarsi Approach Respectively Combined with Arthroscope Assisted reduction and Internal Fixation in Sanders II and III Calcaneal Fracture Surgery. HeBei Med, 2018, 24(7): 1161-1164.
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2018, Vol. 24 
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