[External application of No.II prescription on preoperative detumescence for the treatment of calcaneal fracture through tarsal sinus approach].

Abstract

OBJECTIVE\nTo explore clinical effect of external application of No.II prescription on preoperative detumescence for the treatment of calcaneal fracture through tarsal sinus approach.\n\n\nMETHODS\nFrom November 2016 to June 2018, 67 patients with calcaneal fracture were divided into control group(32 patients with ice compress) and research group(35 patients with external application of No.II prescription) according to different methods of preoperative detumescence. There were 21 males and 14 females in research group, aged from 36 to 52 years old with an average of (44.07±7.31) years old; the time from injury to clinic ranged from 2 to 6 h with an average of(4.32±1.68) h; 9 patients on the left side and 26 patients on the right side; 20 patients were type II, 15 patients were type III according to Sanders classification; treated with external application of No.II prescription. There were 32 patients in control group, including 22 males and 10 females aged from 40 to 52 years old with an average of (46.79±5.47) years old; the time from injury to clinic ranged from 2 to 5 h with an average of (3.89±1.03) h; 14 patients on the left side and 18 patients on the right side; 19 patients were type II and 13 patients were type III according to Sanders classification; treated by ice compress from admission to the first time of occurrence of skin fold. After disappearance of swelling, patients were treated with open reduction and internal fixation through tarsal sinus approach. Cross-section diameter of foot and ankle between admission and the first time of occurrence of skin fold were recorded and calculated the difference value. VAS score on the 2nd, 4th and 7th day after admission, preoperative prepare time, operative time, period of hospitalization and fracture healing time between two groups were compared.\n\n\nRESULTS\nDifference value of cross-section diameter of foot and ankle in research group were (1.72±0.29) cm and (1.69±0.18) cm respectively, while in control group were (1.08±0.21) cm and (0.91±0.37) cm, the level of swelling in research group was better than that of in control group. VAS score on the 2nd, 4th and 7th day after admission in research group were 8.91±0.33, 6.47±1.09, 4.52±0.91 respectively; while in control group were 6.21±0.19, 3.67±1.18, 2.12±1.17 respectively; VAS score in research group was lower than control group. Preoperative prepare time, period of hospitalization and fracture healing time in research group were shorter than control group, while there was no statistical difference in operative time between two groups.\n\n\nCONCLUSIONS\nDuring the perioperative period, rational application of No.IIfor the treatment of calcaneal fracture through tarsal sinus approach could effectively relieve wound swelling, shorten preoperative preparation and fracture healing time, alleviate pain, improve patient satisfaction, and achieve remarkable clinical results.