经跗骨窦入路复位钢板内固定治疗跟骨骨折疗效观察  

Clinical observation on treatment of calcaneal fractures with internal fixation with steel plate by sinus tarsal approach

作　　者：庞渊 张庆 赵光宇 李钊 阿不都克尤木.麦麦提依明 PANG Yuan;ZHANG Qing;ZHAO Guangyu;LI Zhao;Abdudeyoumu Maimaitiyiming(Department of Orthopedics,Traditional Chinese Medicine Hospital,Urumqi 830000,China;Department of Urology,the First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]乌鲁木齐市中医医院骨伤科,乌鲁木齐830000 [2]新疆医科大学第一附属医院泌尿外科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2018年第6期702-705,710,共5页Journal of Xinjiang Medical University

基　　金：乌鲁木齐市卫生局科技计划项目(201328)

摘　　要：目的观察经跗骨窦入路复位钢板内固定治疗跟骨骨折的疗效。方法收集2015年6月-2017年6月在乌鲁木齐市中医医院骨伤科住院的跟骨骨折SandersⅡ、Ⅲ型手术治疗患者60例,随机分成观察组和对照组,每组30例,经跗骨窦入路复位钢板内固定手术治疗者为观察组,采用"L"形切口切开复位内固定手术者为对照组。比较2组患者术前和术后3个月的跟骨Bohler角、Gissane角;平均手术时间、术后引流量、住院时间及骨折愈合时间;切口感染、皮缘坏死、腓肠神经损伤、创伤性关节炎术后并发症发生率;采用踝-后足评分系统(AOFAS)评分评价术后6个月的优良率。结果 2组患者术前和术后3个月的跟骨Bohler角、Gissane角比较差异均有统计学意义(P<0.05);2组患者术后3个月的跟骨Bohler角、Gissane角比较差异无统计学意义(P>0.05)。2组患者平均手术时间、骨折愈合时间比较差异无统计学意义(P>0.05);术后引流量、住院时间比较差异有统计学意义(P<0.05)。观察组术后并发症发生率为9.99%;对照组术后并发症发生率为16.66%,2组比较差异有统计学意义(P<0.05);观察组采用踝-后足评分系统(AOFAS)评分优良率为93.33%,对照组采用踝-后足评分系统(AOFAS)评分优良率为90.00%,2组比较差异有统计学意义(P<0.05)。结论经跗骨窦入路复位钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折能较好的恢复跟骨正常结构和关节功能,与"L"形切口切开复位内固定术相比具有术后引流量少、住院时间短、术后并发症低的优点。Objective To observe the effect of the treatment of calcaneal fracture with internal fixation with steel plate by sinus tarsal approach.Methods 60 cases of Sanders Ⅱ and Ⅲ of calcaneus fracture treated in the orthopedics department of Urumqi traditional Chinese medicine hospital were collected from June 2015 to June 2017,and were randomly divided into 30 groups：Observation group treated with internal fixation with steel plate by tarsal sinus approach,and 30 cases were treated by operation of internal fixation with＂L＂incision.The Bohler angle and Gissane angle of calcaneus before operation and 3 months after operation were compared between both groups.The average operative time,postoperative drainage volume,hospitalization time and fracture healing time,incision infection,skin edge necrosis,sural nerve injury and postoperative complication rate of traumatic arthritis were also compared in both groups.The AOFAS score was used to evaluate the good rate of 6 months after the operation.Results The Bohler angle and Gissane angle of the calcaneus in both groups were statistically significant before and 3 months after the operation（P〈0.05）.There was no statistical significance in the Bohler angle and Gissane angle of calcaneus for 3 months after operation（P〉0.05）.The average operation time and fracture healing time of the 2 groups were not statistically significant（P〈0.05）,The postoperative flow rate and hospitalization time were statistically significant（P〈0.05）.The incidence of postoperative complications in the observation group was 9.99%.The incidence of postoperative complications in the control group was 16.66%.There was a statistically significant difference between both groups.The excellent and good rate of AOFAS score in the observation group was 93.33%,while AOFAS score in the control group was 90%.There was a statistically significant difference between both groups（P〈0.05）.Conclusion The treatment of Sanders Ⅱ and type Ⅲ calcaneal fractures by the tarsal sinus approa

关 键 词：跟骨骨折 跗骨窦入路 钢板内固定 

分 类 号：R683.4[医药卫生—骨科学]