跗骨窦有限切口内固定术对SandersⅡ、Ⅲ型跟骨关节内骨折患者足踝功能及并发症的影响  

Effects of sacral sinus limited incision and internal fixation on foot and ankle function and complications in patients with SandersⅡandⅢintra-articular fractures

作　　者：张军 黄楠 李发灿 武永刚 齐明 ZHANG Jun;HUANG Nan;LI Fa-can(Second Division of Beijing Armed Police Corps Hospital,Beijing 100027,China;Department of Orthopedics,First Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650000,China)

机构地区：[1]武警北京市总队医院外二科,北京100027 [2]昆明医科大学第一附属医院骨科,云南昆明650000

出　　处：《临床和实验医学杂志》2020年第14期1522-1525,共4页Journal of Clinical and Experimental Medicine

基　　金：北京市科技计划项目(编号:KJ2016CX034-04)。

摘　　要：目的观察跗骨窦有限切口内固定术对SandersⅡ、Ⅲ型跟骨关节内骨折患者的足踝功能和并发症的影响。方法采用前瞻性试验方法,选取2014年1月至2018年10月武警北京市总队医院外二科收治的125例SandersⅡ、Ⅲ型跟骨关节内骨折患者,采用随机双盲对照法将其随机分为两组:对照组(n=62)和研究组(n=63)。对照组患者行外侧“L”形切口内固定术,研究组患者行跗骨窦有限切口内固定术。比较两组患者的手术相关指标[手术时间、切口长度、术中出血量、术后视觉模拟评分(VAS)、骨折愈合时间]以及治疗前后的足踝功能(Bohler角、Gissane角、Langre角、跟骨宽度)以及并发症发生情况。结果研究组患者的手术时间(55.95±8.42 min vs.92.48±9.37 min)、切口长度(3.49±1.24 cm vs.8.34±2.15 cm)、术中出血量(62.48±5.37 ml vs.87.95±7.59 ml)、术后VAS评分(4.29±1.30分vs.6.28±1.48分)均优于对照组,差异具有统计学意义(P<0.05);骨折愈合时间(110.95±20.83 d vs.112.98±24.51 d)组间比较差异无统计学意义(P>0.05);治疗后,两组患者的Bohler角(29.58±2.59°vs.30.25±3.59°)、Gissane角(128.57±17.93°vs.125.87±16.59°)、Langre角(93.58±9.65°vs.92.58±8.26°)、跟骨宽度(28.01±4.24°vs.27.49±3.59°)比较差异无统计学意义(P>0.05);研究组患者的并发症发生率低于对照组(9.52%vs.32.26%),差异具有统计学意义(P<0.05)。结论跗骨窦有限切口内固定术能够获得与常规外侧“L”形切口内固定术基本相同的治疗效果,但前者的手术时间更短、组织创伤更低、并发症更少,兼具较好的有效性和安全性,更利于患者术后快速康复。Objective To observe the tarsal sinus limited incision fixation of SandersⅡ,Ⅲankle function and complications in patients with intra-articular calcaneal fractures.Methods A prospective trial method was used to select 125 patients with Sanders II and III intra-articular fractures admitted to the Second Department of Beijing Armed Police Hospital from January 2014 to October 2018.The patients were divided into two groups,including control group(n=62)and study group(n=63).Patients in the control group underwent lateral"L"incision and internal fixation,and patients in the study group underwent limited iliac sinus internal fixation.Surgical related indicators[operation time,incision length,intraoperative blood loss,postoperative visual analogue scale(VAS),fracture healing time],foot and ankle function(Bohler angle,Gissane angle before and after treatment)and complications were compared between the two groups.Results In the study group,the operation time(55.95±8.42 min vs.92.48±9.37 min),the length of the incision(3.49±1.24 cm vs.8.34±2.15 cm),the intraoperative blood loss(62.48±5.37 ml vs.87.95±7.59 ml),and the postoperative VAS score(4.29±1.30 points vs.6.28±1.48 points)were better than the control group,the difference was statistically significant(P<0.05);fracture healing time(110.95±20.83 d vs.112.98±24.51 d)was not statistically significant between groups(P>0.05).After treatment,the Bohler angle(29.58±2.59°vs.30.25±3.59°),Gissane angle(128.57±17.93°vs.125.87±16.59°),Langre angle(93.58±9.65°vs.92.58±8.26°),followed by the two groups of patients,followed by Bone width(28.01±4.24?vs.27.49±3.59?)was not significantly different(P>0.05).The incidence of complications in the study group was lower than that in the control group(9.52%vs.32.26%),and the difference was statistically significant(P<0.05).Conclusion The limited incision internal fixation of tarsal sinus can achieve basically the same therapeutic effect as the conventional external L-shaped incision internal fixation,but the operation

关 键 词：跟骨关节内骨折 SandersⅡ、Ⅲ型 跗骨窦有限切口内固 定术 足踝功能 并发症 

分 类 号：R687.3[医药卫生—骨科学]