Clinical study on percutaneous minimally invasive hollow screw internal fixation for the treatment of calcaneus bone fractures based on lower limb biomechanical evaluation

doi:10.3877/cma.j.issn.2096-0263.2025.01.007

Abstract

Abstract:

Objective

To study the clinical efficacy of percutaneous minimally invasive hollow screw internal fixation for the treatment of calcaneus bone fractures and its impact on lower limb biomechanics in patients.

Methods

94 patients with calcaneus bone fractures who were treated in our hospital from February 2020 to January 2022 were selected and divided into groups using a random number table method.The control group consisted of 47 patients who received open reduction and internal fixation with steel plates， while the study group consisted of 47 patients who received percutaneous minimally invasive hollow screw internal fixation.Compare the perioperative related indicators，preoperative and postoperative imaging parameters，biomechanical indicators，ankle function，complications，and quality of life between the two groups.

Results

The study group had less intraoperative blood loss compared to the control group，while the surgical duration，incision length，hospitalization，and fracture healing time were shorter than the control group（P＜0.05）.At 3 months after surgery，the scores of Bohler angle，Gissane angle，and WHOQOL-BREF in both groups significantly increased，while the calcaneal width，tibial torsion，femoral internal rotation，forefoot valgus，and femoral external rotation significantly decreased（P＜0.05）；3 months after surgery，the scores of Bohler angle，Gissane angle，and WHOQOL-BREF in the study group were higher than those in the control group， while the calcaneal width，tibial torsion，femoral internal rotation，forefoot valgus，and femoral external rotation were lower than those in the control group（P＜0.05）.The excellent and good rate of ankle function in the study group（95.74%）was higher than that in the control group（78.72%）（P＜0.05）.The incidence of complications in the study group（4.26%）was lower than that in the control group（19.15%）（P＜0.05）.

Conclusion

Percutaneous minimally invasive hollow screw internal fixation for the treatment of calcaneus bone fractures has a definite therapeutic effect，which can effectively promote the recovery of ankle function in patients，improve lower limb biomechanics，and have fewer complications and faster recovery，helping to improve quality of life.

Key words: Foot calcaneus bone fracture, Percutaneous minimally invasive hollow screw internal fixation, Biomechanics, Ankle function, Complication

Ruichen Deng, Hongyan Xiao, Xinyun Wei, Weiyin Yang, Yungang Xie. Clinical study on percutaneous minimally invasive hollow screw internal fixation for the treatment of calcaneus bone fractures based on lower limb biomechanical evaluation[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2025, 11(01): 46-51.

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Figures/Tables 8

组别	例数	性别（男/ 女，例）	年龄（岁， $\overset{ˉ}{x}$ ±s）	受伤原因（高处坠落/ 交通事故，例）	BMI（kg/m²， $\overset{ˉ}{x}$ ±s）	Sanders 骨折分型（Ⅱ 型/Ⅲ 型，例）	骨折位置（左侧/右侧，例）
对照组	47	26/21	45.82±6.18	30/17	22.89±2.16	28/19	25/22
研究组	47	29/18	46.27±6.51	32/15	22.53±2.05	30/17	23/24
χ ²/t值		0.642	0.354	0.247	0.864	0.235	0.364
P值		0.423	0.724	0.619	0.39	0.628	0.546

组别	例数	性别（男/ 女，例）	年龄（岁， $\overset{ˉ}{x}$ ±s）	受伤原因（高处坠落/ 交通事故，例）	BMI（kg/m²， $\overset{ˉ}{x}$ ±s）	Sanders 骨折分型（Ⅱ 型/Ⅲ 型，例）	骨折位置（左侧/右侧，例）
对照组	47	26/21	45.82±6.18	30/17	22.89±2.16	28/19	25/22
研究组	47	29/18	46.27±6.51	32/15	22.53±2.05	30/17	23/24
χ ²/t值		0.642	0.354	0.247	0.864	0.235	0.364
P值		0.423	0.724	0.619	0.39	0.628	0.546

	例数	术中失血量（ml）	手术时长（min）	切口长度（cm）	住院时间（d）	骨折愈合时间（d）
对照组	47	78.44±7.24	62.48±7.14	8.58±1.35	12.25±2.26	65.36±8.23
研究组	47	62.85±6.95	50.61±6.38	4.48±1.29	8.54±1.85	53.85±7.66
t 值		10.650	8.499	15.053	8.709	7.018
P值		＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

组别	例数	BÖhler角（°）		Gissane 角（°）		跟骨宽度（mm）
组别	例数	术前	术后3个月	术前	术后3个月	术前	术后3 个月
对照组	47	13.25±2.19	27.56±2.81*	95.85±7.69	120.65±8.76*	40.65±4.33	34.20±3.14*
研究组	47	13.06±2.12	33.15±3.66*	96.41±7.92	130.58±9.28*	40.16±4.28	28.15±3.05*
t 值		0.427	8.305	0.348	5.335	0.552	9.475
P 值		0.670	＜0.001	0.729	＜0.001	0.583	＜0.001

组别	例数	胫骨扭转		股骨内旋
组别	例数	术前	术后3个月	术前	术后3个月
对照组	47	13.69±2.05	10.85±1.97^*	45.36±3.85	40.22±3.52^*
研究组	47	13.45±2.11	8.05±1.58^*	44.92±3.76	36.12±2.87^*
t 值		0.559	7.601	0.561	6.189
P 值		0.577	＜0.001	0.577	＜0.001
组别	例数	前足外翻		股骨外旋
组别	例数	术前	术后3个月	术前	术后3个月
对照组	47	6.85±1.35	4.28±1.12^*	45.32±3.96	41.61±3.11^*
研究组	47	6.68±1.38	3.05±1.06^*	44.85±4.02	38.25±2.85^*
t值		0.604	5.468	0.571	5.461
P 值		0.548	＜0.001	0.569	＜0.001

组别	例数	优	良	可	差	优良
对照组	47	23（48.94）	14（29.79）	6（12.77）	4（8.51）	37（78.72）
研究组	47	29（61.70）	16（34.04）	1（2.13）	1（2.13）	45（95.74）
χ ²值						6.114
P 值						0.013

组别	例数	切口感染	皮肤坏死	创伤性关节炎	腓肠神经炎	合计
对照组	47	3（6.38）	1（2.13）	2（4.26）	3（6.38）	9（19.15）
研究组	47	1（2.13）	1（2.13）	0	0	2（4.26）
χ ²值						5.045
P 值						0.025

组别	例数	社会关系		环境		心理		生理
组别	例数	术前	术后3 个月	术前	术后3个月	术前	术后3个月	术前	术后3个月
对照组	47	60.26±5.36	70.65±6.84^*	58.32±5.16	68.85±6.33^*	55.85±5.06	67.54±6.24^*	52.66±4.98	68.95±6.52^*
研究组	47	60.77±5.42	79.88±7.69^*	57.69±5.29	80.24±7.68^*	56.32±5.41	77.85±7.48^*	52.91±5.02	81.05±7.45^*
t 值		0.459	6.148	0.585	7.846	0.435	7.256	0.242	8.379
P 值		0.648	＜0.001	0.560	＜0.001	0.665	＜0.001	0.809	＜0.001

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