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| Effect of external fixator pinning in anterior process of calcaneus combined with mini-open reduction and internal fixation in treatment of distal tibia comminuted fracture |
| ZHANG Haisen1 LIU Chang1 LIANG Dongqi2 WANG Huailiang3 PEI Baojing3 LIU Hui4 LIU Ying5 |
1.Derpatment of Sports Medicine, Cangzhou Central Hospital, Hebei Province, Cangzhou 061001, China;
2.Derpatment of Pain Management, Cangzhou Central Hospital, Hebei Province, Cangzhou 061001, China;
3.the Sencod Derpatment of Orthopedics, Cangzhou Central Hospital, Hebei Province, Cangzhou 061001, China;
4.Derpatment of Orthopedics, Mumendian Hospital of Qingxian, Hebei Province, Qingxian 062650, China;
5.Operating Room, Cangzhou People′s Hospital, Hebei Province, Cangzhou 061001, China |
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Abstract Objective To investigate clinical effect of external fixator pinning in anterior process of calcaneus combined with mini-open reduction and internal fixation in treatment of distal tibia comminuted fracture. Methods The clinical data of 19 patients with closed distal tibial comminuted fracture who received external fixator pinning in anterior process of calcaneus combined with mini-open reduction and internal fixation in the Derpatment of Orthopedics, Cangzhou Central Hospital in Hebei Province from January 2014 to January 2016 were retrospectively analyzed. During the operation, external fixation screws of the distal end of the fractures were placed in medial posterior side of the calcaneus and about 1 cm of sustentaculum of talus of calcaneus. A limited incision was made in the anterior medial side of the ankle, and screw fixation was adopted after the anatomical reduction of the distal articular surface fracture of the tibia. External fixator was relaxed for 1 time per week after postoperative 4 weeks in order to exercise motion of ankle. The perioperative data and follow-up data were analyzed to evaluate the postoperative clinical effect. Results The mean operation time was (58.6±15.4) min, the average intraoperative blood loss was (201.5±78.6) mL, and the average hospitalization time was (14.2±2.8) d. Two cases (10.5%) had postoperative superficial inflammatory reaction around fibular incision, and one case (5.3%) had postoperative infection of external fixation screw track, which healed well after treatment. No neurological or vascular injury complications occurred in all patients. The incidence of perioperative complications was 15.8%. The patients were followed up for 13 to 15 months. All fractures were healed without loss of reduction. There was no statistically significant difference between the Lowa ankle score and the visual analogue scale pain score at each postoperative follow-up time point (P ＞ 0.05). According to the Maryland score, the good rate of the curative effect was 84.2%. Conclusion External fixator pinning in anterior process of calcaneus combined with mini-open reduction and internal fixation in treatment of distal tibia comminuted fracture has good clinical effect, reliable fixation and low complication rate, which is an alternative surgical treatment method.
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