关键词: 跟骨骨折, 腓骨肌腱鞘, 后足功能

Abstract: Objective In the patients with calcaneal fractures,the surgical method with intact peroneal tendon sheath was used to treat them,and compared with the traditional surgical method with dynamic retraction of the peroneal tendon,to analyze the influence of the surgical method on the posterior foot movement.Methods A retrospective analysis was made on 60 patients with calcaneal fracture admitted to the Department of Orthopaedics of our hospital from December 2016 to December 2020.The patients were divided into two groups according to the surgical method.The patients in the distraction group received the surgical treatment of traditional dynamic distraction of peroneal tendon (28 cases),and the patients in the preservation group received the surgical treatment of preserving the integrity of peroneal tendon sheath (32 cases).The outcome measures included perioperative indicators, Maryland score of foot function 12 months after surgery, AOFAS score of posterior foot and imaging indicators (Boler Angle and Gissane Angle) 12 months after surgery.Results The surgical time (89.34±12.21 minutes) and hospitalization time (5.26±1.47 days) of the retention group were significantly better than those of the traction group[（124.22±11.56）min,(11.59±2.43)d] (P<0.05).At the last follow-up,the AOFAS score (70.56 ± 3.62) and Maryland’s excellent and good rate (87.5%) of patients in the retention group were better than those in the traction group（81.37±3.58，71.4%）(P<0.05).The difference in imaging indicators between the two groups was relatively small (P>0.05).Conclusion The surgical method of keeping the peroneal tendon sheath intact in the treatment of patients with calcaneal fracture has definite clinical effects,and can also effectively reduce the adverse effects of surgical trauma on posterior foot activity.

Key words: calcaneal fracture, peroneal tendon sheath, ankle-hindfoot scale