不同入路切口内固定治疗SandersⅢ型跟骨骨折的近远期疗效比较  

Comparison of Long-dated Curative Effect of Sanders TypeⅢ Calcaneal Fractures with Different Approaches to Incision Internal Fixation Treatment

作　　者：徐剑锋[1] 谢学义[1] 李金生[1] 丁东胜 邹祝艺 

机构地区：[1]东莞市黄江医院,广东东莞523750

出　　处：《四川医学》2017年第2期174-177,共4页Sichuan Medical Journal

摘　　要：目的观察不同入路切开复位内固定方案治疗SandersⅢ型跟骨骨折的近远期疗效。方法选取2009年5月至2014年5月我院收治的60例SandersⅢ型跟骨骨折患者作为研究对象,按治疗方式不同将其分为A、B两组,A组34例,采用经跗骨窦小切口复位内固定方案;B组26例,接受外侧L形切口钢板内固定方案。比较两组近远期疗效,术后两组均随访1年,参照AOFAS踝-后足评分系统评估患者骨折恢复情况,采用VAS评估患者疼痛程度改善情况,并统计术后并发症发生率。结果 1A组优良率为88.24%,显著高于B组的65.38%,两组治疗优良率差异有统计学意义(P<0.05);2术后及末次随访A组Gissane角分别为(118.08±6.65)°、(116.73±7.06)°,与B组差异有统计学意义(P<0.05);3术后、末次随访A组评分分别为(16.68±4.39)分、(2.67±0.96)分,均显著低于B组,两组差异有统计学意义(P<0.05);4A组术后并发症发生率为8.82%,显著低于B组的46.15%,两组术后并发症发生率差异有统计学意义(P<0.05)。结论在SandersⅢ型跟骨骨折患者的临床治疗中,采用经跗骨窦小切口复位内固定方案,可优化骨折复位效果,促进患者Gissane角形态恢复,降低术后并发症发生率,有较高的临床应用价值。Objective The long-dated curative effect of Sanders type Ⅲ calcaneal fractures with different approaches to open reduction and internal fixation treatment was observed.Methods 60 cases of Sanders type Ⅲ calcaneal fractures patients selected from May 2009 to May 2014 in the Dongguan Huangjiang Hospital were divided into two groups according to the treatment.The group A of 34 cases was given small incision through tarsal sinus with reduction and internal fixation,the group B of 26 cases was underwent lateral L incision with plates internal fixation. The long-dated curative effect of two groups was compared and both are followed up for one year postoperatively.The fracture＇s recovery condition was estimate according to AOFAS scoring system,the improvement of pain degree was assessed with VAS and the incidence of postoperative complications was calculated. Results 1 The good rate in group A was 88. 24%,which was significantly higher than that of group B 65. 38%.The differences of two groups was statistically significant（ P〈0. 05）; 2 The Gissane Angle of group A in the postoperative and final follow-up was（ 118. 08 ±6. 65） °,（ 116. 73±7. 06） ° respectively,and the difference compared with group B was statistically significant（ P〈0. 05）; 3 The score of group A in the postoperative and final follow-up was（ 16. 68±4. 39）,（ 2. 67±0. 96） respectively and those were significantly lower than that of group B,so the difference was statistically significant（ P〈0. 05）; 4 The incidence of postoperative complications of group A was 8. 82%,which was significantly lower than the 46. 15% of the group B,the difference of postoperative complications incidence between the two groups had statistical significance（ P〈0. 05）. Conclusion In the clinical treatment of patients with Sanders Type Ⅲ alcaneal fractures,using small incision through tarsal sinus with reduction and internal fixation can optimize the effect of the fracture reduction,promote Gissane Angle shape recovery and reduce t

关 键 词：跟骨骨折 SandersⅢ型 内固定 切口 疗效 

分 类 号：R687.32[医药卫生—骨科学]