Abstract:

BACKGROUND: Calcaneal fractures with subtalar arthritis were treated with bone graft fusion in the clinic, but previous big “L” approach could cause great trauma to patients, and was not conducive to the patient’s recovery.
OBJECTIVE: To explore the repair effect of modified small “L” approach in bone fusion Kirschner wire on calcaneal fractures with subtalar arthritis.
METHODS: Clinical data of 23 patients with calcaneal fracture with subtalar arthritis in the First Hospital-Fengtai Hospital, Peking University from November 2012 to November 2013 were retrospectively analyzed. All patients received modified bone graft fusion via small “L” approach. Repair effect was observed. American Orthopaedic Foot and Ankle Society scores and hind foot scores were evaluated before and after treatment.
RESULTS AND CONCLUSION: Bone graft fusion was successfully conducted in 23 patients. The operation time was 55-90 minutes, averagely (70±2.5) minutes. All incision was healed well after operation. Wound infection or flap necrosis did not occur. During follow-up, patients reached bone healing, and no talus osteonecrosis or bone absorption appeared. By the time of the last follow-up, AOFAS score of 23 patients was (85.6±3.7), which was 
significantly higher than (50.3±6.2) points before treatment (P < 0.05). These results suggest that modified bone graft fusion with small “L” approach for calcaneal fracture with subtalar arthritis obtained good clinical effects.Moreover, the operation was simple and the complications were less. This method can effectively solve the insufficient exposure of inside of the subtalar joint via previous approaches and big processing difficulty. 
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Calcaneus, Fractures, Bone, Subtalar Arthritis, Osteoarthritis, Internal Fixators, Tissue Engineering