“八”字微创入路内固定治疗跟骨骨折疗效观察  

Curative effect observation of minimally invasive incision combined with plate fixation for calcaneal fractures

作　　者：马骏[1] 何斌[1] 姜曙祥[1] 王强[1] 田锋[1] 盛福卫 

机构地区：[1]石河子大学医学院附属第三医院骨科,新疆石河子832000

出　　处：《局解手术学杂志》2017年第4期256-259,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：八师石河子市科技计划项目(2016HZ23)

摘　　要：目的观察"八"字微创入路联合钢板内固定治疗跟骨骨折的疗效。方法对2014年8月至2015年8月采用微创小切口(即跗骨窦切口结合跟骨后纵外侧切口)联合钢板内固定治疗的30例(30足)跟骨骨折患者资料进行回顾性研究,所有患者采用"八"字形微创切口联合钢板治疗跟骨骨折;术后拍摄X射线片明确骨折愈合情况,测量B9hler角与Gissane角,记录相关并发症;采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足评分系统评估疗效。结果所有患者术后获12~16个月(平均14.5个月)随访,所有骨折均愈合,无切口感染或切口不愈合等并发症发生。跟骨B9hler角由术前平均(13.42°±4.2°)恢复至末次随访时的(29.3°±3.8°),差异有统计学意义(t=-20.424,P=0.000);跟骨Gissane角由术前平均(97.8°±9.7°)恢复至末次随访时的(123.6°±6.5°),差异有统计学意义(t=-17.5,P=0.000)。经AOFAS踝与后足评分系统评估,患者优良率达83.3%。结论 "八"字微创入路内固定治疗跟骨骨折具有创伤小、切口并发症少、复位固定可靠的优点,疗效满意。Objective To analyze the curative effect of minimally invasive incision combined with plate fixation for ealeaneal fractures. Methods Retrospectively analyzed the clinical data of 30 cases （30 feet） of caleaneal fractures who were treated with minimal incision（ sinus tarsi approach combined with posterior lateral incision） from August 2014 to August 2015. Minimally invasive incision combined with plate fixation were performed for the treatment. X-rays were taken in the regular follow-up, Bohler and Gissane angle as well as the complications were measured. The final curative effect was comprehensively assessed according to the ankle hind foot score of American Aryhopaedic Foot and Ankle Society（AOFAS）. Results All cases were followed up for an average of 14.5 months （ from 12 to 16 months） , and all fractures healed with no complication such as incision infection or poor healing. The average Btihler angle was improved from preoperative（ 13.42° ± 4.2° ） to （29.3 ° ± 3.8 ° ） at the last follow-up with a significant difference （ t = - 20. 424, P = 0. 000 ） , and the average Gissane angle was significantly improved from preoperative （97.8 ° ± 9.7 ° ） to （ 123.6 ° ± 6.5° ） at the last follow-up （ t = - 17.5, P = 0. 000 ）. The outcomes were evaluated with AOFAS,resulting in an excellent and good rate of 83.3%. Conclusion Treatment of ealeaneal fractures with minimal incision has the advantages of less trauma,lower incision complication rate, stronger reduction and fixation, which can achieve satisfactory out- comes.

关 键 词：小切口 内固定 微创治疗 跟骨骨折 手术入路 

分 类 号：R683.4[医药卫生—骨科学]