经跗骨窦切口复位内固定与跟骨外侧L形切口复位内固定治疗SandersⅡ、Ⅲ型跟骨骨折的临床对比研究  

Clinical comparative study of sinus tarsi incision reduction and internal fixation and lateral L-shaped incision reduction and internal fixation in the treatment of Sanders type Ⅱ and Ⅲ calcaneous fracture

作　　者：程刚[1] 赵雷 Cheng Gang;Zhao Lei(Department of Orthopedic and Traumatic Surgery,the Second People's Hospital of Yunnan Province,Kunming 650021,China)

机构地区：[1]云南省第二人民医院骨与创伤外科,昆明650021

出　　处：《中国医学前沿杂志（电子版）》2020年第5期75-79,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的比较经跗骨窦切口复位内固定与跟骨外侧L形切口复位内固定治疗SandersⅡ、Ⅲ型跟骨骨折的临床效果。方法选取2015年9月至2018年9月于云南省第二人民医院住院治疗的40例SandersⅡ、Ⅲ型跟骨骨折患者为研究对象,根据手术方法将其分为研究组(20例)和对照组(20例),研究组患者采取经跗骨窦切口复位内固定,对照组患者采取跟骨外侧L形切口复位内固定。比较两组患者手术相关指标、手术前后和末次随访的功能指标、手术前后视觉模拟评分法(visual analogue scale,VAS)评分、Maryland足功能评分、优良率、术后早期和晚期并发症发生情况。结果研究组患者手术时间、切口长度、住院天数均显著短于对照组(均P<0.05),术中出血量显著少于对照组(P<0.05),两组患者骨折愈合时间比较差异无统计学意义(P>0.05)。术后和末次随访时,两组患者Bohler角和Gissane角均显著大于本组术前(均P<0.05),距下关节面移位均显著小于本组术前(均P<0.05),但上述指标组间比较差异均无统计学意义(均P>0.05)。术后,两组患者VAS评分均显著低于本组术前(均P<0.05),Maryland足功能评分均显著高于本组术前(均P<0.05),且研究组患者VAS评分显著低于同期对照组(P<0.05),Maryland足功能评分显著高于同期对照组(P<0.05)。两组患者手术优良率比较差异无统计学意义(P>0.05)。研究组患者距下关节僵硬发生率显著低于对照组(P<0.05),但两组患者切口感染、切口边缘坏死、创伤性关节炎和腓肠神经损伤发生率比较差异均无统计学意义(均P>0.05)。结论与跟骨外侧L形切口复位内固定相比,经跗骨窦切口复位内固定治疗SandersⅡ、Ⅲ型跟骨骨折的效果较好,且手术创伤小、术后疼痛程度低、住院天数短,具有一定的临床应用价值。Objective To evaluate the clinical efficacy of sinus tarsi incision reduction and internal fixation and lateral L-shaped incision induction and internal fixation in the treatment of Sanders type Ⅱ and Ⅲ calcaneous fracture.Method 40 patients with Sanders Ⅱ and Ⅲ calcaneous fracture treated in the Second People's Hospital of Yunnan Province from September 2015 to September 2018 were divided into study group(n=20)and control group(n=20).Patients in study group were treated with sinus tarsi incision reduction and internal fixation,and patients in control group were treated with lateral L-shaped incision reduction and internal fixation.The operation related indexes,functional indexes before and after operation and the last follow-up,visual analog scale(VAS)before and after operation,Maryland foot function score and excellent and good rate,early and late postoperative complications were compared between the two groups.Result The operation time,incision length and hospital day in study group were significantly shorter than those in control group(all P<0.05),and the amount of bleeding in the operation was significantly less than that in control group(P<0.05),but there was no significant difference in the time of fracture healing between the two groups(P>0.05).After operation and at the last follow-up,the Bohler angle and Gissane angle of the two groups were significantly larger than those before operation(all P<0.05),and the displacement of inferior articular surface was smaller than that before operation(all P<0.05),but there were no significant differences in the above indexes between the two groups(all P>0.05).After operation,the VAS scores of the two groups were significantly lower than those of before operation(all P<0.05),and the Maryland foot function scores were significantly higher than those of before operation(all P<0.05),and the VAS score of study group was significantly lower than that of control group(P<0.05),the Maryland foot function score was significantly higher than that of control group(P<0.0

关 键 词：跟骨骨折 Sanders分型 复位 内固定 

分 类 号：R687.3[医药卫生—骨科学]