The Comparison of Clinical Efficacy of Minimally Invasive Tarsal Sinus Approach and L-Type Incision Approach Combined with 3D Printing Technology in Calcaneal Fracture

Abstract

Purpose. To explore the comparison of the reduction of the subtalar articular surface and other postoperative effects of the minimally invasive tarsal sinus approach and lateral L-shaped incision conventional approach for the treatment of calcaneal fracture with 3D printing technology. Methods. Patients who received surgical treatment for calcaneal fractures in the First Affiliated Hospital of Henan University of Science and Technology from June 2019 to December 2020 were collected. 3D printing equipment produced the affected side reduction heel bone fracture model and navigation template model. The tarsal sinus approach was used in the experimental group, and the lateral L-shaped incision approach was used in the control group. Patients were followed up 3 days, 1 month, 3 months, 6 months, and 12 months after the operation. Imaging indicators were measured 12 months after surgery, and scores from American Foot and Ankle Orthopaedic Society (AOFAS) and MSF were performed. Results. Operation time was $70.52\pm 13.16$ in the control group and $55.24\pm 12.25$ minutes in the experimental group ( $P<0.001$ ). Intraoperative blood loss was $98.77\pm 18.65$ in the control group and $89.56+17.54$ in the experimental group ( $P>0.05$ ). The duration of antibiotic use was $5.53\pm 3.24$ days in the control group and $5.48\pm 4.18$ days in the experimental group ( $P>0.05$ ). The frequency of fluoroscopy was $6.56\pm 1.72$ in the control group and $3.88\pm 1.05$ in the experimental group ( $P<0.001$ ). Fracture healing time was $3.24\pm 0.52$ months in the control group and $3.08\pm 0.58$ months in the experimental group ( $P>0.05$ ). The postoperative Böhler angle was $28.31\pm 3.14$ in the control group and $29.24\pm 2.76$ in the experimental group ( $P>0.05$ ). Postoperative subtalar articular displacement ( $\text{step}>2$  mm) was observed in 4 patients in the control group and 1 in the experimental group ( $P<0.05$ ). MSF score was $90.12\pm 4.85$ in the control group and $91.36\pm 2.58$ in the experimental group ( $P>0.05$ ). Conclusion. The study found that the experimental group was significantly better than the control group in terms of the operation time, intraoperative fluoroscopy times, and success rate of reduction of the subtalar articular surface. 3D printing technology can shorten the operation time, accurately reduce the fracture block, and reduce the secondary trauma, which is conducive to the functional recovery of the affected foot.