关键词: 跟骨骨折,  ,  ,  , 跗骨窦切口,  ,  ,  , 微创

Abstract:

Objective　To explore the minimally invasive treatment of Sanders Ⅲ calcaneal fractures with mini-plate and internal column screw.　Methods　The clinical data of 31 cases with Sanders type III calcaneal fracture treated by modified tarsal sinus incision with mini-plate and medial column screw from January 2016 to December 2016 was retrospectively analyzed. Among them, there were 21 males and 10 females, aged 22~43 years, with an average age of 32.4 years. 18 were on the left and 13 on the right. Postoperative complications were counted and differences before and after operation of Bohler's angle, Gissane's angle, calcaneal height and width were compared.  Finally，AOFAS（Ankle and hind foot scoring system）was used to evaluate the clinical efficacy.　Results　All the 31 patients were followed up from 21 to 23.8 months, and the average follow-up time was 22.5 months. All patients achieved bone union, and the mean duration of fracture healing was 5.1 months. At the last follow-up, Bohler angle, Gissane angle, calcaneal height and calcaneal width were significantly different from those before operation (P<0.01). AOFAS score increased from (64.3±1.1) preoperatively to (85.7±3.2) postoperatively, of which 22 were excellent and 5 were good. There were no common complications such as wound infection, skin flap necrosis, peroneal tendon irritation, internal fixation exposure, sural nerve injury and so on.　Conclusions　Modified tarsal sinus incision for Sanders type III calcaneal fracture has the advantage of convenient operation and sufficient exposure of articular surface. Fixation with mini-plate and medial column screw can prevent calcaneal varus and reduce complications after operation.

Key words: Calcaneal fracture, 　Tarsal sinus incision, 　Minimally invasion