微创与外侧扩大入路治疗跟骨骨折的疗效比较  

Minimally invasive approach versus extended lateral approach in treatment of calcaneal fractures

作　　者：刘东[1] 阳波[1] 米宁[1] 罗斌[1] 兰家平[1] LIU Dong;YANG Bo;MINing;LUO Bin;LAN Jiaping(First Ward of Depamnent of Orthopedics,Suining Central Hospital,Suining,Siehuan 629000,China)

机构地区：[1]遂宁市中心医院骨科一病区,四川遂宁629000

出　　处：《现代临床医学》2018年第6期437-440,共4页Journal of Modern Clinical Medicine

摘　　要：目的:对比分析微创与外侧扩大入路治疗SandersⅡ和Ⅲ型跟骨骨折的疗效。方法:收集2013年1月至2016年1月收治的60例跟骨骨折,随机分为微创组(采用跗骨窦入路)和传统组(采用外侧扩大入路)进行治疗,各30例。比较两组手术相关指标;比较两组术前和术后跟骨B9hler角、Gissane角、宽度和高度。结果:两组术前等待时间、住院时间差异有统计学意义(P <0. 05);在手术时间、术中出血量、末次随访AOFAS评分方面两组差异无统计学意义(P> 0. 05)。两组术后末次随访与术前跟骨B9hler角、Gissane角、宽度、高度比较差异有统计学意义(P <0. 05),但两组间术前、术后比较差异均无统计学意义(P> 0. 05)。微创组并发症发生率低于传统组,但差异无统计学意义(6. 7%vs 16. 7%,P>0. 05)。结论:微创与外侧扩大入路切开复位内固定治疗SandersⅡ和Ⅲ型跟骨骨折,可获得相似的临床及影像学结果,但前者术前等待时间与住院时间更短、术后切口发生并发症的风险更低。Objective： To comparatively analyze the therapeutic effect of minimally invasive approach and extended lateral approach in the treatment of ealeaneal fractures. Methods：From January 2013 to January 2016, 60 cases of ealeaneal fractures were randomly divided into two groups ： minimally invasive group （ using tarsal sinus approach ） and the traditional group （ using lateral enlarged approach）, 30 cases in each group. The operation-related indexes were compared between the two groups; the Bishler angle, Gissane angle, width and height of ealeaneus were also compared before and after operation between the two groups. Results：There were significant differences in preoperative waiting time and hospitalization time between the two groups （P 〈 0. 05 ）, and no significant differences were found in operative time, intraoperative bleeding volume and AOFAS score at the last follow-up between the two groups （ P 〉 0. 05 ）. There were significant differences in BiShler angle, Gissane angle, width and height between the two groups at the last follow-up and before operation （ P 〈 0. 05 ）, but there was no significant difference between the two groups before and after operation （ P 〉 0. 05 ）. The incidence of complications in the minimally invasive group was lower than that in the traditional group, but the difference was not statistically significant （6. 7% vs 16. 7% , P 〉 0. 05 ）. Conclusion ：Similar clinical and imaging results can be obtained through minimally invasive approach and extended lateral approach for the internal fixation of Sanders type II and III ealeaneal fractures, but the former had shorter preoperative waiting time and hospital stay-, and lower risk of postoperative incision complications.

关 键 词：SANDERS Ⅱ和Ⅲ型 跟骨骨折 微创 外侧扩大入路 切开复位内固定术 

分 类 号：R658.3[医药卫生—外科学]