两种切口内固定治疗SandersⅡ、Ⅲ型跟骨骨折  

Two kinds of incisions internal fixation for treatment of Sanders typeⅡ,Ⅲcalcaneal fracture

作　　者：叶猛 张保[1] 曹溢 董俊[1] 项辉[1] 贾其余 YE Meng;ZHANG Bao;CAO Yi;DONG Jun;XIANG Hui;JIA Qi-yu(Dept of Orthopaedics,the Second People′s Hospital of Hefei,Hefei,Anhui 230011,China)

机构地区：[1]合肥市第二人民医院骨科,安徽合肥230011

出　　处：《临床骨科杂志》2020年第6期895-898,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较跗骨窦切口与L形切口复位内固定治疗SandersⅡ、Ⅲ型跟骨骨折的临床疗效。方法将68例SandersⅡ、Ⅲ型跟骨骨折患者根据手术切口不同分为两组:32例采用跗骨窦切口复位内固定(A组),36例采用L形切口复位内固定(B组)。比较两组手术时间、术中出血量、住院时间、切口并发症、Böhler角和Gissane角,末次随访时采用疼痛VAS评分、AOFAS踝-后足评分评价疗效。结果患者均获得随访,时间6~18个月。术中出血量及住院时间A组均少(短)于B组(P<0.05)。术后及末次随访时两组Böhler角、Gissane角均较术前显著增加(P<0.05),两组间比较差异均无统计学意义(P>0.05)。末次随访时VAS评分和AOFAS踝-后足评分两组比较差异均无统计学意义(P>0.05)。术后切口并发症发生率A组低于B组,差异有统计学意义(P<0.05)。结论跗骨窦切口与L形切口均为治疗SandersⅡ、Ⅲ型跟骨骨折的有效入路,但跗骨窦入路患者住院时间短,术中出血量少,术后并发症少。Objective To compare the clinical outcomes of Sanders typeⅡ,Ⅲcalcaneal fractures treated with the sinus tarsi incision and the L-shaped incision.Methods Sixty-eight patients with Sanders typeⅡ,Ⅲcalcaneal fractures were divided into two groups according to different surgical incision,32 patients were treated with the sinus tarsi incision reduction internal fixation(group A)and 36 patients were treated with the L-shaped incision reduction internal fixation(group B).Operative time,intraoperative blood loss,hospitalization time,postoperative incision complications,Böhler angle and Gissane angle were compared,Visual analogue scale(VAS)and AOFAS ankle-hindfoot score at the last follow-up were used to evaluate the efficacy.Results All patients were followed up for 6~18 months.The intraoperative blood loss volume and hospitalization time of the group A were less(shorter)than those of the group B(P<0.05).Böhler angle and Gissane angle were significantly increased in both groups the postoperation and the last follow-up(P<0.05),while there wasn′t difference between the two groups(P>0.05).There were no significant differences in VAS and AOFAS ankle-hindfoot score at the last follow-up between two groups(P>0.05).Group A was lower than group B in the postoperative incision complications incidence rate(P<0.05).Conclusions The sinus tarsi incision and the L-shaped incision are both effective approaches for the treatment of Sanders typeⅡ,Ⅲcalcaneal fractures,but the sinus tarsi incision has a shorter hospital stay,less intraoperative bleeding,and fewer postoperative complications.

关 键 词：跟骨骨折 骨折固定术 内 跗骨窦切口 L形切口 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]