两种不同手术入路对距骨体sneppenⅡ型骨折的治疗效果对比观察  

Comparison of the Therapeutic Effects of Two Different Surgical Approaches in Sneppen Ⅱ Talus Fracture

作　　者：王晓锋[1] 巫红波 张志文[1] 陈锐雄[1] 梁浩锋 WANG Xiaofeng;WU Hongbo;ZHANG Zhiwen;CHEN Ruixiong;LIANG Haofeng(Department of Orthopedics, Huizhou Centeral People's Hospital of Guangdong Province, Huizhou 516001,China)

机构地区：[1]广东省惠州市中心人民医院骨科

出　　处：《包头医学院学报》2019年第7期22-24,共3页Journal of Baotou Medical College

摘　　要：目的:探讨分析两种不同手术入路对距骨体sneppenⅡ型骨折的效果。方法:选取2016年3月至2018年3月收治的40例距骨体sneppenⅡ型骨折患者随机分为观察组和对照组,观察组给予内外侧联合入路切开复位内固定治疗,对照组给予内侧入路切开复位内固定治疗,比较两组临床疗效、手术时间、骨折愈合时间、愈合率,术前、术后1年AOFAS、VAS评分,术后1年创伤性关节炎发生率。结果:观察组临床疗效优良率为85.00%,手术时间、骨折愈合时间显著缩短,骨折愈合率为100.00%,与对照组比差异显著(P<0.05);手术前两组AOFAS、VAS评分无统计学差异(P>0.05);术后1年两组AOFAS评分均显著提高,VAS评分均显著降低,且观察组AOFAS评分上升更显著,VAS评分下降更显著(P<0.05);术后1年观察组创伤性关节炎发生率显著性降低(P<0.05)。结论:内外侧联合入路切开复位内固定治疗SneppenⅡ型距骨体骨折可显著提高临床疗效,缩短手术时间,促进骨折愈合,缓解患者疼痛,降低创伤性关节炎的发生,促进足部功能恢复,建议在临床上推广。Objective:To investigate the effect of two different surgical approaches in the treatment of sneppen Ⅱ talus fractures. Methods: 40 patients with skeletal sneppen Ⅱ talus fracture, admitted to the hospital from March 2016 to March 2018, were selected and randomly divided into the observation group and the control group. The observation group was treated with the combination of medial surgical approach and lateral surgical approach for open reduction and internal fixation, and the control group was treated with medial approach for open reduction and internal fixation. Such factors were compared between the two groups as the clinical efficacy, operation time, fracture healing time, healing rate, AOFAS 1 year before and after operation, VAS score, and incidence of traumatic arthritis 1 year after the operation. Results:The clinical efficacy rate in the observation group was 85.00 %. The operation time and fracture healing time were significantly shortened. The fracture healing rate was 100.00 %, significantly different from those in the control group(P<0.05). There was no significant difference in the AOFAS and VAS scores between the two groups before the operation(P >0.05). The AOFAS scores significantly increased and the VAS scores significantly decreased in the two groups 1 year after operation, with the AOFAS scores in the observation group significantly higher than that in the control group, and the VAS scores significantly lower than that in the contro group(P<0.05). The incidence of traumatic arthritis significantly decreased(χ~2=3.906, P=0.048) 1 year after the operation. Conclusion:The combination of medial surgical approach and lateral surgical approach for open reduction and internal fixation in Sneppen type Ⅱ talus fracture can significantly improve clinical efficacy, shorten operation time, promote fracture healing, and relieve patients’ pain, reduce the occurrence of traumatic arthritis, and promote the recovery of foot function, and it is recommended to be popularized clinically.

关 键 词：内侧手术入路 外侧手术入路 sneppenⅡ距骨体骨折 

分 类 号：R687.3[医药卫生—骨科学]