跗骨窦切口钢板结合空心螺钉治疗跟骨骨折疗效及对围术期指标和足踝功能恢复的影响  

The curative efficacy of tarsal sinus incision steel-plate combined with cannulated screw in the treatment of calcaneal fractures and its effects on perioperative indicators and recovery of foot-ankle function

作　　者：李磊[1] 兰家平[1] 阳波[1] 王志强[1] 胡超 温洋 LI Lei;LAN Jia-ping;YANG Bo;WANG Zhi-qiang;HU Chao;WEN Yang(Department of Orthopedics,Suining Central Hospital,Suining 629000,China)

机构地区：[1]四川省遂宁市中心医院骨科,四川遂宁629000

出　　处：《实用医院临床杂志》2020年第6期189-192,共4页Practical Journal of Clinical Medicine

摘　　要：目的观察跗骨窦切口钢板结合空心螺钉治疗跟骨骨折疗效及对围术期指标和足踝功能恢复的影响。方法我院收治的104例跟骨骨折患者,根据治疗方法分为对照组(外侧扩大“L”形切口切开复位钢板内固定术)50例,观察组(跗骨窦切口钢板结合空心螺钉内固定术)54例。比较两组围手术期指标,记录术前、术后3个月的影像学指标,术前、术后6个月足踝关节功能变化情况,通过并发症发生率情况评估安全性。结果观察组术中出血量、手术切口长度、手术时间、术后引流量、住院时间、骨折愈合时间低于对照组(P<0.05);术后3个月,两组Bohler角、Gissane角、跟骨高度较术前上升,观察组Bohler角、Gissane角高于对照组(P<0.05);两组跟骨宽度较术前降低(P<0.05),两组间跟骨高度、跟骨宽度比较差异无统计学意义(P>0.05);术后6个月,两组AOFAS量表分级比较,差异有统计学意义,观察组总改善率高于对照组(P<0.05);两组伤口感染、切口皮肤坏死、腓骨肌腱激惹、创伤性关节炎、腓肠神经损伤发生率比较,差异无统计学意义(P>0.05)。结论跗骨窦切口钢板结合空心螺钉与传统外侧L型切口钢板内固定治疗均可有效促进跟骨骨折患者骨折复位,改善其跟骨高度及跟骨宽度,且两者术后并发症相当,但前者具有手术时间短、失血量少、切口小等特点,更有利于患者术后足踝关节恢复。Objective To observe the efficacy of tarsal sinus incision steel-plate combined with cannulated screw in the treatment of calcaneal fractures and its effects on perioperative indicators and recovery of foot-ankle function of patients.Methods The clinical data of 104 patients with calcaneal fractures treated in our hospital were retrospectively analyzed.The patients were grouped according to treatment methods,including 50 cases in control group(open reduction steel-plate internal fixation with increased lateral L-shaped incision)and 54 cases in observation group(tarsal sinus incision steel-plate combined with cannulated screw internal fixation).The perioperative indicators were compared between the two groups,and the imaging indicators before surgery and after 3 months of surgery and foot-ankle function before surgery and after 6 months of surgery were recorded.The safety was evaluated by incidence rates of related complications during follow-up.Results The intraoperative blood loss,incision length,operative time,postoperative drainage volume,hospital stay and fracture healing time in the observation group were significantly lower or shorter than those in the control group(P<0.05).After 3 months of surgery,the Bohler angle,Gissane angle and calcaneal height in the two groups of patients were significantly higher than those before surgery,and the Bohler angle and Gissane angle in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the calcaneal width of the two groups was significantly reduced compared with that before surgery(P<0.05),and there were no statistically significant differences in the calcaneal height and width between the two groups(P>0.05).After 6 months of surgery,there was a statistically significant difference in the AOFAS scale classification between the two groups(P<0.05).During follow-up,there were no statistically significant differences in the incidence rates of wound infection,incision skin necrosis,fibula tendon irritation,traumatic arthrit

关 键 词：跗骨窦 钢板 空心螺钉 跟骨骨折 疗效 围术期指标 足踝功能 

分 类 号：R683.42[医药卫生—骨科学]