摘要
目的对比经微创跗骨窦切口与传统改良“L”型切口治疗SandersⅡ、Ⅲ型跟骨骨折的疗效。方法收集80例2016年4月—2019年5月本院骨伤科确诊为SandersⅡ、Ⅲ型跟骨骨折患者,不限性别,年龄在22~65周岁。根据手术入路方式不同将其分为跗骨窦切口组(n=44)和传统切口组(n=36)。跗骨窦切口组择期行经微创跗骨窦切口微创钢板螺钉内固定手术,传统切口组择期行传统外侧改良“L”型切口钢板螺钉内固定手术,观察两组患者手术前后跟骨各部位角度、跟骨高度及宽度,并根据Maryland评分对两组患者手术前后疗效进行分析。结果跗骨窦切口组术后随访平均(15.34±2.32)个月,传统组(17.40±2.24)个月,所有骨折均获得骨性愈合。跗骨窦切口组跟骨Böhler角、Gissane角以及高度、宽度与传统切口组手术后比较差异无统计学意义(P>0.05);跗骨窦切口组临床总治疗有效率为95.45%,高于传统切口组94.44%,但组间比较差异无统计学意义(P>0.05)。结论经跗骨窦切口内固定与传统“L”型切口内固定均能够恢复跟骨解剖结构,疗效相似,但微创跗骨窦切口操作简单、创伤小,术后切口不良反应少,距下关节僵硬发生率更低,是一种值得推广的可靠的跟骨骨折微创治疗方法。
Objective To compare the effects of minimally invasive tarsal canal operation and conventional modified“L”type incision on treatment of SandersⅡandⅢcalcaneal fracture.Methods 80 SandersⅡandⅢcalcaneal fracture patients(without limitation of gender,aged 22-65)treated from April 2016 to May 2019 in our hospital were selected.According to different operation approaches,patients were divided into tarsal canal approach group(n=44)and conventional approach group(n=36).The tarsal canal approach group selectively took plate-screw internal fixation via minimally invasive tarsal canal operation;the conventional approach group selectively took plate-screw internal fixation via conventional modified“L”type incision.Calcaneal angles,height and width were observed;curative effects were appraised by Maryland scores.Results The average follow-up visit period in tarsal canal approach group and conventional approach group was(15.34±2.32)months and(17.40±2.24)months.The bone healing was successful.Böhler angle,Gissane angle,calcaneal height and width between groups showed no statistically significant difference(P>0.05);total effective rate in tarsal canal approach group(95.45%)was higher than conventional approach group(94.44%),without statistically significant difference(P>0.05).Conclusion Both of the internal fixation via minimally invasive tarsal canal operation and conventional modified“L”type incision can promote the recovery of calcaneal anatomical structure.However,the minimally invasive tarsal canal operation can simply the surgical procedures,reduce the clinical trauma,adverse reactions and incidences of subtalar joint stiffness.The reliable therapy is worthy of clinical promotion.
作者
陈封明
焦锋
费奉龙
唐东鸣
CHEN Fengming;JIAO Feng;FEI Fenglong;TANG Dongming(Department of Orthopedics,Guangzhou Integrated Chinese and WesternMedicine Hospital,Guangzhou Guangdong 510800,China)
出处
《中国卫生标准管理》
2021年第16期20-23,共4页
China Health Standard Management
基金
广州市花都区科技计划项目(17-HDWS-056)。
