摘要
目的比较分析经跗骨窦切口与跟骨外侧L形切口复位钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折的临床疗效。方法回顾性分析自2014-01-2016-12诊治的79例SandersⅡ、Ⅲ型跟骨骨折,42例采用经跗骨窦切口复位微型钢板内固定手术治疗(微创组),37例采用跟骨外侧L形切口复位钢板内固定手术治疗(常规组)。比较2组受伤至手术时间、切口长度、手术时间、术后疼痛VAS评分、术后切口并发症发生率,术后12个月跟骨Bohler角、Gissane角,以及术后12个月Maryland足部功能评分。结果 79例均获得随访,随访时间平均13.8(13~16)个月。术后6个月骨折均愈合,骨折愈合时间平均4.2(3~6)个月。与常规组比较,微创组受伤至手术时间、手术时间更短,切口长度更短,术后疼痛VAS评分更低,术后切口并发症发生率更低,差异有统计学意义(P <0.05)。微创组与常规组术后12个月Bohler角、Gissane角、Maryland足部功能评分比较差异无统计学意义(P>0.05)。结论经跗骨窦切口复位微型锁定钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折创伤相对较小,术后切口并发症发生率显著降低,同时能够获得满意的骨折复位和内固定强度,术后足部功能恢复满意。
Objective To compare the clinical effect of tarsi approach and external L-shaped approach with plate internal fixation for treatment of Sanders type Ⅱ and Ⅲ calcaneal fractures.Methods Seventy-nine patients with Sanders type Ⅱ and Ⅲ calcaneal fractures between January 2014 and December 2016 were retrospectively analyzed.Forty -two cases underwent the sinus tarsi approach (minimally invasive group),compared with the 37 cases with the external L-shaped approach (conventional group).The time from injury to operation,incisive length,operation time,postoperative complications rate were compared to evaluate the surgical effect.At 12 months postoperatively,the Bohler angle,Gissane angle,the visual analog scale (VAS),and Maryland foot score were also compared.Results All the 79 cases were followed up.The average follow-up time was 13.8 (13-16) months.All fractures healed at 6 months after operation.The average fracture healing time was 4.2 (3-6) months.The time from injury to operation,operation time,incisive length,and VAS score in minimally invasive group were lower than that in conventional group (P <0.05).There were no statistical differences in the postoperative Bohler angle,Gissane angle,and Maryland foot score between the two groups (P >0.05).Conclusion The tarsi approach for Sanders type Ⅱ and Ⅲ calcaneal fractures has lesser trauma and fewer postoperative complications,with satisfactory fracture reduction,internal fixation intensity and restoration of the foot function.
作者
高峰
王秀会
周小小
易存国
付备刚
王明辉
沈超
夏胜利
GAO Feng;WANG Xiu-hui;ZHOU Xiao-xiao;YI Cun-guo;FU Bei-gang;WANG Ming-hui;SHEN Chao;XIA Sheng-li(Department of Orthopedics,Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital,Shanghai Pudong New District Zhoupu Hospital,Shanghai 201318,China)
出处
《中国骨与关节损伤杂志》
2019年第8期822-825,共4页
Chinese Journal of Bone and Joint Injury
基金
上海市浦东新区卫生系统重点学科群建设项目（PWZxq2017-12）
上海健康医学院种子基金项目（SFP-18-22-17-003）
上海市浦东新区周浦医院重中之重学科建设项目(ZP-XK-2015A-2)
