纵行微创入路与跗骨窦微创入路内固定治疗Sanders Ⅱ、Ⅲ型跟骨骨折疗效对比  

Minimally invasive longitudinal approach versus sinus tarsal approach for treating Sanders Ⅱ and Ⅲ calcaneal fractures

作　　者：蒋维利[1] 董斌[1] JIANG Weili;DONG Bin(Department of Orthopedics,Huainan First Peopled Hospital,Huainan 232007,Anhui,China)

机构地区：[1]淮南市第一人民医院骨科

出　　处：《中华骨与关节外科杂志》2019年第10期800-804,共5页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:SandersⅡ、Ⅲ型跟骨骨折临床上常采用手术治疗,以恢复解剖结构和足部功能,接骨板内固定术在临床上取得良好的疗效,但其手术创伤大,易引发术后并发症,且术后恢复时间较长。微创手术应用于骨折治疗能显著降低术后并发症,缩短手术和康复时间,降低治疗费用。目的:比较纵行微创入路(MILA)与跗骨窦微创入路(STA)内固定治疗SandersⅡ、Ⅲ型跟骨骨折的临床效果。方法:选取2016年3月至2017年4月收治的70例SandersⅡ、Ⅲ型跟骨骨折患者为研究对象,患者按随机数字法被分成MILA组和STA组,各35例。对比两组患者的手术时间、术后并发症、影像学指标和临床疗效。结果:两组患者均获得随访,随访时间为12~18个月,平均(14.2±3.1)个月。MILA组手术时间低于STA组(t=14.736,P<0.001);两组患者术前和术后B?hler角和Gissane角比较,差异无统计学意义(P>0.05);MILA组切口愈合并发症发生率低于STA组(χ2=4.629,P=0.031),其余并发症(腓肠肌神经损伤、足底内侧神经损伤等)两组差异无统计学意义(P>0.05);两组足部功能评分差异无统计学意义,其中活动限制、疼痛和行走距离功能评分差异无统计学意义,而MILA组在行走路面的功能评分明显高于STA组(t=6.751,P<0.001)。结论:MILA和STA内固定治疗SandersⅡ、Ⅲ型跟骨骨折,手术时间短,术后并发症少,提高患者临床疗效,安全性好,值得临床推广。Background: Sanders Ⅱ and III calcaneal fractures are often treated by surgery to restore the anatomical structure and foot function. Internal fixation with bone plate has a good clinical effect, but the operation is traumatic, easy to cause postoperative complications, and the postoperative recovery time is long. The application of minimally invasive surgery in fracture treatment can significantly reduce postoperative complications, shorten the time of operation and rehabilitation, and reduce the cost of treatment. Objective: To explore the efficacy of minimally invasive longitudinal approach(MILA) versus sinus tarsal approach(STA) for treating SandersⅡ and Ⅲ calcaneal fractures. Methods: Seventy patients with SandersⅡ or Ⅲ calcaneal fractures treated in our hospital from March 2016 to April 2017 were selected and divided into the MILA group and the STA group by random number table, 35 patients in each group. The operation time, postoperative complications, imaging indexes and clinical efficacy were compared between the two groups. Results: The patients in both groups were followed up for 12-18 months with the average of(14.2±3.1) months. The operation time was significantly lower in MILA group than in STA group(t=14.736, P<0.001);the differences in B?hler’s angle and Gissane’s angle before and after operation were not statistically significant(P>0.05) between the tow groups;the incidence of incision healing complications in MILA group was significantly lower than that of STA group(χ2=4.629, P=0.031), the rest of the complications such as gastrocnemius nerve injury and medial plantar nerve injury were not significantly different between the two groups(P>0.05);there were no statistically significant differences in foot function scores including activity restriction, pain and walking distance between the two groups. The difference in function scores of walking pavement was significantly higher in MILA group than in STA group(t=6.751, P<0.001). Conclusions: Both MILA and STA internal fixation method

关 键 词：纵行微创入路 跗骨窦微创入路 疗效 

分 类 号：R687.3[医药卫生—骨科学]