跗骨窦入路微创钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折  

Minimally Invasive Plate via Sinus Tarsi Approach for Sanders TypeⅡandⅢCaleaneus Fractures

作　　者：沈杰[1] 姜雪峰[1] 黄国伟[1] 徐军[1] Shen Jie;Jiang Xuefeng;Huang Guowei(Department of Orthopaedics, Jiangyin People’s Hospital, Jiangyin 214400, China)

机构地区：[1]江苏省江阴市人民医院骨关节中心,江阴214400

出　　处：《中国微创外科杂志》2020年第6期540-544,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：无锡市卫计委项目(201708)。

摘　　要：目的探讨经跗骨窦入路联合微创钢板治疗SandersⅡ、Ⅲ型跟骨骨折的临床疗效。方法2012年6月~2018年1月,对123例(137足)SandersⅡ、Ⅲ型跟骨骨折行跗骨窦入路微创钢板内固定,其中Ⅱ型95足,Ⅲ型42足。观察术后跟骨骨折复位、腓肠神经损伤和伤口情况,采用美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足指数评分评价疗效。结果所有跟骨均恢复解剖形态。1例深部感染,10例腓肠神经损伤。术后随访12~96(39.8±11.3)月。22例(25足)获得5年以上随访,AOFAS评分(83.5±12.1)分;46例(50足)获得3~5年随访,AOFAS评分(86.4±9.1)分;55例(62足)获得1~3年随访,AOFAS评分(87.9±7.3)分。共62例(67足)术后12~51(20.7±8.5)月行内固定取出,1例腓肠神经损伤,无伤口感染。结论经跗骨窦入路联合微创钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折操作简单,固定可靠,术后可早期功能锻炼,是治疗跟骨骨折的有效方法。Objective To investigate the clinical effect of sinus tarsi approach minimally invasive plate in the treatment of Sanders typeⅡandⅢcalcaneal fractures.Methods A total of 123 patients(137 feet)with calcaneal fractures were treated with minimally invasive plate internal fixation from June 2012 to January 2018.According to Sanders classification,95 feet were typeⅡand 42 feet were typeⅢ.The reduction of calcaneal fracture after operation,postoperative sural nerve injury and wounds,and the American Orthopedic Foot and Ankle Society(AOFAS)ankle-hindfoot index score were used to evaluate the efficacy.Results All the patients recovered their calcaneal anatomy.Deep infection was found in one case and sural nerve injury in 10 cases.All the patients were followed up for 12-96 months(mean,39.8±11.3 months).In 22 cases(25 feet)followed up for more than 5 years,the average AOFAS score was(83.5±12.1)points.In 46 cases(50 feet)followed up for 3-5 years,the average AOFAS score was(86.4±9.1)points.In 55 cases(62 feet)followed up for 1-3 years,the average AOFAS score was(87.9±7.3)points.The plate of 62 cases(67 feet)were removed 12-51(20.7±8.5)months after operation.One case had sural nerve injury and no wound infection was found.Conclusion The treatment of calcaneal fracture with sinus tarsi approach minimally invasive plate is easy to operate and reliable in fixation,with early postoperative functional exercise,which is an effective method for the treatment of calcaneal fracture.

关 键 词：跟骨骨折 跗骨窦手术入路 微创钢板 

分 类 号：R68[医药卫生—骨科学]