跗骨窦微创切口治疗舌型跟骨骨折对患者伤口愈合、腓肠神经的影响  

Influence of minimally invasive incision of tarsal sinus on wound healing and sural nerve in the treatment of patients with linguiform calcaneus fracture

作　　者：刘剑军[1] 谢静波[1] 鄢秋元[1] LIU Jian-jun;XIE Jing-bo;YAN Qiu-yuan(The First Department of Orthopedics,Fengcheng People's Hospital,Jiangxi Province,Fengcheng 331100,China)

机构地区：[1]江西省丰城市人民医院骨一科,江西丰城331100

出　　处：《中国当代医药》2019年第13期138-141,共4页China Modern Medicine

摘　　要：目的探讨跗骨窦微创切口治疗舌型跟骨骨折对患者伤口愈合、腓肠神经的影响。方法选取2013年1月～2018年1月我院收治的53例舌型跟骨骨折患者作为研究对象,按照随机数字表法分为观察组(n=28)和对照组(n=25)。对照组患者接受传统"L"形切口复位钢板螺钉内固定治疗,观察组患者接受跗骨窦微创切口松质骨螺钉+自制小钢板内固定治疗。比较两组手术相关指标、骨折愈合时间、3个月后复查情况及并发症发生情况。结果观察组的手术切口长度、手术时间及骨折愈合时间明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P<0.05);两组治疗后的跟骨长度、跟骨高度、跟骨宽度、Bohler角(跟骨结构关节角)及Gissane角(跟骨交叉角)比较,差异无统计学意义(P>0.05);观察组的并发症总发生率(3.57%)明显低于对照组(32.00%),差异有统计学意义(P<0.05)。结论采用跗骨窦微创切口治疗舌型跟骨骨折损伤,对关节面解剖结构复位具有较好的效果,手术创伤小、操作简便、骨折愈合快、并发症少,临床推广应用价值较高。Objective To investigate the influence of minimally invasive incision of tarsal sinus on wound healing and sural nerve in the treatment of patients with linguiform calcaneus fracture.Methods A total of 53 patients with linguiform calcaneus fracture admitted to our hospital from January 2013 to January 2018 were selected as the study subjects,they were divided into observation group(n=28)and control group(n=25)according to random number table method.Patients in the control group were treated with traditional"L"incision reduction and plate and screw internal fixation,while patients in the observation group were treated with minimally invasive tarsal sinus incision cancellous bone screw and self-made small plate internal fixation.The operation related indexes,fracture healing time,review after 3 months and complications were compared between the two groups.Results The incision length,operation time and fracture healing time of the observation group were significantly shorter than those of the control group,and the amount of bleeding during the operation was significantly less than that of the control group,the differences were statistically significant(P<0.05).There were no significant differences in calcaneal length,calcaneal height,calcaneal width,Bohler angle(calcaneal joint angle)and Gissane angle(calcaneal cross angle)between the two groups after treatment(P>0.05).The total incidence of complications in the observation group(3.57% )was significantly lower than that in the control group(32.00% ),and the difference was statistically significant(P<0.05).Conclusion Minimally invasive tarsal sinus incision for treatment of linguiform calcaneus fracture injury has a good effect on the reduction of articular surface anatomical structure.It has the advantages of less trauma,simple operation,quick fracture healing and fewer complications.It has a high clinical application value.

关 键 词：舌型跟骨骨折 跗骨窦微创切口 内固定 伤口愈合 腓肠神经 

分 类 号：R274.12[医药卫生—中医骨伤科学]