经跗骨窦切口入路治疗SandersⅡ、 Ⅲ型跟骨骨折的疗效分析  

Efficacy analysis on internal fixation of through sinus tarsi approach and conventional lateral L shape approach

作　　者：李云鹏 张路[1] 赵文志[1] LI Yunpeng;ZHANG Lu;ZHAO Wenzhi(Department of Traumatic Orthopedics,the Second Affiliated Hospital of Dalian Medical University,Dalian 116027,China)

机构地区：[1]大连医科大学附属第二医院创伤骨科,辽宁大连116027

出　　处：《大连医科大学学报》2018年第1期33-38,46,共7页Journal of Dalian Medical University

基　　金：国家自然科学基金项目(31270999)

摘　　要：目的对比分析经跗骨窦入路及传统外侧L型扩展入路治疗跟骨Sanders Ⅱ、Ⅲ型跟骨骨折的疗效。方法将2014年12月至2016年5月入院治疗并符合标准的47例跟骨骨折患者根据手术入路分为两组(传统外侧L切口入路组25例和跗骨窦切口入路组22例)。比较两组患者的手术时间、住院时间、愈合时间、术后随访功能及并发症的发生情况,并对术前术后Bohler角及Gissane角的大小进行测量。术后随访1~18个月,采用AOFAS评分评价足部功能。结果传统外侧L切口入路组较跗骨窦切口入路组患者手术时间更长(P<0.05);两组在骨折愈合时间、AOFAS评分、术后Bohler及Gissane角恢复等方面差异无显著性意义(P>0.05)。结论与传统外侧L切口入路对比,经跗骨窦切口入路治疗Sanders Ⅱ、Ⅲ型跟骨骨折可以取得较满意的临床结果,具有一定的优势,但需严格掌握适应证,术者需有传统术式经验积累。Objective To compare and analyze the curative efficacy of internal fixation of Sanders type II&III calcaneal fractures through sinus tarsi approach and conventional lateral L shape approach.Methods Forty-five cases of Sanders type II&III calcaneal fractures between December of 2014 and May of 2016 were enrolled and divided into groups A(conventional lateral L shape approach:25 cases)and B(sinus tarsi approach:22 cases).The operation time,hospital stay,healing time,postoperative follow-up,and complications were compared and analyzed.The preoperative&postoperative angle of Bohler and Gissane were measured and analyzed as well.The patients were followed up at 1,3,6,12,and 18 month.Results The conventional laterel L shape approach got a longer operation time than the sinus tarsi one(P<0.05).There are no significant differences between the two grasps in healing time.AOFAS scores,angle of Bohler and Gissane of post-operation(P>0.05).Conclusion Compared with the conventional lateral L shape approach,the Sanders type II&III calcaneal fractures treated by sinus tarsi approach got satisfied clinical results,with a shorter operation time and low skin complications.But surgeon need to grasp the indications strictly and should have the experience of traditional operation.

关 键 词：跟骨骨折 跗骨窦入路 内固定 

分 类 号：R863.42[医药卫生—临床医学]