微创闭合复位内固定与传统切开复位内固定治疗跟骨骨折疗效分析  

Therapeutic effect of calcaneal fractures with minimally invasive closed fixation and traditional open reduction fixation

作　　者：刘明 钱宇航[1] 尹豫[1] 周勇 王义兵 步建立[1] LIU Ming;QIAN Yu-hang;YIN Yu;ZHOU Yong;WANG Yi-bing;BU Jian-li(The Second Department of Orthopaedics, Bethune International Peace Hospital of PLA, Shijiazhuang 050082, China)

机构地区：[1]中国人民解放军白求恩国际和平医院骨二科,河北石家庄050082

出　　处：《河北医科大学学报》2020年第6期665-669,共5页Journal of Hebei Medical University

摘　　要：目的探讨微创闭合复位内固定与传统切开复位内固定治疗跟骨骨折的疗效,提出新的确定跟骨骨折复位的参考标准。方法回顾性分析SandersⅡ型跟骨骨折患者58例,随机分为对照组及观察组各29例,对照组采用传统跟骨外侧L形切口切开复位内固定,观察组采用微创经皮撬拨闭合复位内固定。对比2组患者手术时间、术中出血量、住院费用、切口并发症、B?hler角和Gissane角、胫距跟弧线、二次取出内固定手术时间等观察指标。结果观察组在手术时间、术中出血量、切口并发症、住院费用、二次取出内固定手术时间、术中出血量、住院费用上明显优于对照组(P<0.05)。复位良好的跟骨骨折,胫骨后缘、距骨后缘、跟骨后缘最高点的连线是一条平顺的弧线,且与距骨后缘最高点相切的弧线的曲率同健侧相比较大致相同。结论微创闭合复位内固定与传统切开复位内固定治疗跟骨骨折均有疗效,但微创闭合复位内固定能减少手术时间、术中出血量、切口并发症、住院费用及二次取出内固定手术时间、术中出血量、住院费用,值得临床推广应用。胫距跟弧线对跟骨骨折复位情况具有参考价值。Objective To study the efficacy of minimally invasive closed fixation and traditional open internal fixation intraarticular calcaneal fractures.A new reference standard for determining the reduction of calcaneal fractures is proposed.Methods Retrospective analysis of 58 cases of SandersⅡcalcaneal fractures admitted to our hospital,and they randomly divided into 29 cases in the control group and 29 cases in the observation group.The control group was the traditional lateralⅠ-incision reduction and internal fixation of the calcaneus.The observation group was closed reset internal fixation with minimally invasive percutaneous priming.Surgical time,intraoperative bleeding,hospital expenses,incision complications,B?hler and Gissane angles,tibia and arc,fixed operation time in secondary extraction,etc were compared.Results The observation group was superior to the control group in the time of operation,the amount of bleeding during surgery,the complication of incision,the cost of hospitalization,the fixed time of surgery,the amount of bleeding during surgery,and the cost of hospitalization(P<0.05).With a well-reduced calcaneal fracture,the connection between the highest point of the posterior edge of the tibia,the highest point of the posterior edge of the talus,and the highest point of the posterior edge of the calcaneus was a smooth arc,and the curvature of the arc tangent to the highest point of the posterior edge of the talus is roughly the same as that of the healthy side.Conclusion The efficacy of minimally invasive closed fixation and traditional open internal fixation in the treatment of calcaneal fractures is true.However,minimally invasive closed internal fixation can greatly reduce surgical time,intraoperative hemorrhage,incision complications,hospitalization costs,and secondary extraction internal fixation time,intraoperative hemorrhage,and hospitalization costs.It is worth clinical application.The tibial distance and arc lines have reference value to the reduction of calcaneal fractures.

关 键 词：骨折 跟骨 外科手术 微创性 

分 类 号：R683[医药卫生—骨科学]