Effect of Sanders type Ⅱ to Ⅲ calcaneal fracture treated by internal fixation of steel plate through Chinese character "八" shaped incision of tarsal sinus approach

Objective To investigate the clinical effect of Sanders type Ⅱ or Ⅲ calcaneal fracture treated by internal fixation of steel plate through Chinese character "八" shaped incision of tarsal sinus approach. Methods The clinical data of 82 patients with Sanders Ⅱ or Ⅲ type calcaneal fractures who were treated by internal fixation was retrospectively analyzed. All patients retained complete clinical operation data and follow-up data at least 12 months after operation. According to different surgical approaches, the patients were divided into minimally invasive group(n=37)and conventional group(n=45). The minimally invasive group received internal fixation of steel plate through Chinese character "八" shaped incision of tarsal sinus approach, and the conventional group received classical open reduction with lateral L-shaped incision approach and plate internal fixation. The operation related indicators, complications and ankle function recovery at 12 months after operation were compared. Results There were no significant differences in operation time and hospitalization time between the two groups(P>0.05). the amount of bleeding in the minimally invasive group was(37.82±10.04)mL, which was less than(62.29±13.20)mL in the conventional group, and the rate of incision-related complications was 10.81%, which was lower than 31.11% in the conventional group, the differences were statistically significant(P<0.05); The follow-up results of 12 months after operation showed that there were no serious complications such as internal fixation failure, fracture nonunion or malunion. There were no significant differences in Bohler's angle as well as Gissane's - angle of calcaneus at 12 months after operation, fracture healing time and Maryland foot function score between the groups(P>0.05). Conclusion Compared with traditional open reduction with lateral L-shaped incision approach and internal fixation, internal fixation of steel plate through Chinese character "八" shaped incision of tarsal sinus approach can reduce the amount of bleeding and incidence of incision-related complications for Sanders Ⅱ or Ⅲ type calcaneus fracture. The two methods have better efficacy in fracture healing and foot function recovery.