摘要
目的探讨跗骨窦切口对SandersⅡ、Ⅲ型跟骨骨折的治疗效果。方法选取中山大学附属第八医院2019年1月至2021年3月经跗骨窦切口入路治疗的48例SandersⅡ、Ⅲ型跟骨骨折患者进行治疗效果研究,收集围术期常见的并发症发生情况、术中出血量及手术时间;影像学数据:经术前、末次随访的跟骨侧位、轴位X线片测量跟骨长度、宽度、高度、Böhler角、Gissane角;功能指标:采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足功能评分评价术前、末次随访时的患肢功能;采用视觉模拟评分法(visual analogue scale,VAS)评分评价术前、末次随访时的患肢疼痛情况。结果所有患者均顺利完成手术,术后内固定未发生松动、脱落,无骨折移位及骨折不愈合等并发症;术中出血量30~50 ml,平均(40.9±4.5)ml,手术时间60~90 min,平均(73.2±6.8)min。跟骨长度、跟骨高度、Böhler角、Gissane角末次随访比术前均显著增加,差异有统计学意义(P<0.05);跟骨宽度末次随访比术前显著减少,差异有统计学意义(P<0.05)。AOFAS评分末次随访较术前显著提高,差异有统计学意义(P<0.05),末次随访中优13例,良25例,可10例,优良率为79.17%;VAS评分末次随访较术前显著降低,差异有统计学意义(P<0.05)。结论跗骨窦切口入路在SandersⅡ、Ⅲ型跟骨骨折的治疗中较少发生神经血管损伤、感染、皮肤坏死等手术并发症,可以恢复跟骨解剖形态,保证治疗效果,术后恢复效果优良。
Objective To investigate the the therapeutic effect of tarsal sinus incision on SandersⅡandⅢtype calcaneal fractures.Methods A total of 48 Sanders typeⅡandⅢfractures treated by tarsal sinus incision approach from January 2019 to March 2021 in the Eighth Affiliated Hospital,Sun Yat-sen University were selected for the treatment study,and the occurrence of common complications during the perioperative period,intraoperative bleeding and operative time were collected after treatment with internal fixation by tarsal sinus incision approach for all operative;The length,width,height,Bohler angle and Gissane angle of the calcaneus were measured on the lateral and axial X-ray of the calcaneus before operation and at the last follow-up.Functional index:the American Orthopaedic Foot and Ankle Society(AOFAS)ankle and hindfoot score was used to evaluate the function of the affected limb before surgery and at the last follow-up;The visual analogue scale(VAS)was used to evaluate the function of the affected limb before surgery and at the last follow-up.Result All patients successfully completed the operation,and no loosening,loss,fracture displacement,fracture nonunion and other complications occurred in the internal fixation after the operation.The intraoperative blood loss was 30~50 ml(40.9±4.5)ml,and the operative time was 60~90 min(73.2±6.8)min.Calcaneal length,calcaneal height,Bohler Angle and Gissane Angle were significantly increased at the last follow-up compared with those before surgery,with statistical significance(P<0.05).The calcaneal bone width was significantly decreased at the last follow-up compared with that before operation,with statistical significance(P<0.05).At the last follow-up,AOFAS score was significantly higher than that before surgery,the difference was statistically significant(P<0.05).In the last follow-up,13 cases were excellent,25 cases were good,10 cases were fair,and the rate of excellent and good was 79.17%.VAS score at the last follow-up was significantly lower than that before surgery,the difference was statistically significant(P<0.05).Conclusion The tarsal sinus incision approach in the treatment of SandersⅡandⅢfractures is less prone to surgical complications such as neurovascular injury,infection and skin necrosis,can restore the anatomical form of the calcaneal and ensure the therapeutic effect with excellent postoperative recovery.
作者
林方思宇
张宏波
黄爱军
王一民
蔡汉周
武浩
黄醒中
刘雷
Lin Fangsiyu;Zhang Hongbo;Huang Aijun;Wang Yimin;Cai Hanzhou;Wu Hao;Huang Xingzhong;Liu Lei(The Eighth Affiliated Hospital,Sun Yat-sen University(Shenzhen Futian),Shenzhen 518033,China)
出处
《足踝外科电子杂志》
2023年第1期37-40,共4页
Electronic Journal of Foot and Ankle Surgery
基金
国家自然科学基金面上项目(81874002)。
