Efficacy of perioperative hyperbaric oxygen therapy on 44 cases of Sanders type II and III calcaneal fractures treated by percutaneous prying reduction and cannulated screw internal fixation
10.3760/cma.j.cn311847-20200729-00305
- VernacularTitle:围手术期高压氧处理联合经皮撬拨闭合复位空心钉内固定治疗SandersⅡ、Ⅲ型跟骨骨折44例疗效观察
- Author:
Yanfang WU
1
;
Botao HUANG
Author Information
1. 264008 山东省烟台，烟台山医院
- Publication Type:Journal Article
- Keywords:
Perioperative period;
Hyperbaric oxygen;
Percutaneous prying reduction and cannulated screw internal fixation;
Sanders II and III calcaneal fractures
- From:
Chinese journal of nautical medicine and hyperbaric medicine
2020;27(6):650-653,672
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of hyperbaric oxygen (HBO) therapy in perioperative period on calcaneal fractures (CF) of Sanders type II and III treated by percutaneous prying reduction and cannulated screw fixation (PPRCSF).Methods:A total of 81 patients with closed Sanders II and III CF admitted to Yantai Mountain Hospital and Yantai Yuhuangding Hospital from June 2017 to August 2019 were retrospectively analyzed. They were divided into observation group ( n=44) and control group ( n=37). The patients in the control group were given conventional treatment before operation, including raising the affected limb, antibiotic treatment, subsiding swelling treatment with sodium aescinate and mannitol, and then received PPRCSF operation when the heel wrinkle test was positive. The patients in the observation group were treated with HBO during the perioperative period on the basis of the treatment of the control group. On the eighth day after the operation, the incidence of poor blood supply, such as incision swelling, low skin temperature, epidermal blister, and dark skin edge, were observed and recorded. The length of hospital stay and fracture healing time of the patients in the two groups were counted. The curative effect was evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS) score and Maryland score 6 months after operation. The changes of Bohler angle, Gissane angle, and calcaneal height and width of the patients in the two groups before and after treatment were statistically analyzed. Results:Eight days after operation, the incidence rate of poor blood supply at incision in the observation group (11.36%) was significantly lower than that in the control group (29.73%) ( P<0.05). The period from admission to operation, the length of hospital stay, and the fracture healing time in the observation group were significantly less than those in the control group ( P<0.05). All patients were followed up during the 6 months after operation. Six months after operation, AOFAS and Maryland scores of the patients in the two groups were significantly higher than those before operation ( P<0.01), and the AOFAS and Maryland scores of the patients in the observation group were significantly higher than those of the control group ( P<0.05). Compared with those before treatment, Bohler angle and calcaneal width of the patients in the two groups were increased after treatment; Gissane angle and calcaneal height of the patients in the two groups were decreased after treatment; all differences were statically significant ( P<0.05). But there was no significant difference in Gissane angle, Bohler angle, calcaneal width, or calcaneal height between the observation group and the control group ( P>0.05). Conclusion:HBO therapy in perioperative period has good clinical effect on subsiding tissue swelling before operation, and on promoting postoperative wound healing and fracture healing in patients with Sanders II and III CF after PPRCSF, which is worthy of clinical application.
