微创距下关节融合术对陈旧性跟骨骨折患者距骨倾斜角、骨性愈合时间及足部功能的影响  

The effects of minimally invasive subtalar arthrodesis on talar tilt angle,bone healing time and foot function in patients with old calcaneal fractures

作　　者：谢坤南 毕若杰[2] 马姗姗[3] 孙昌俊[2] 李力更[2] XIE Kun-nan;BI Ruo-jie;MA Shan-shan;SUN Chang-jun;LI Li-geng(The Second Hospital of Tangshan city,Tangshan 063000,China)

机构地区：[1]唐山市第二医院关节二科,河北唐山063000 [2]唐山市第二医院急诊科,河北唐山063000 [3]唐山市第二医院科教科,河北唐山063000

出　　处：《武警后勤学院学报（医学版）》2021年第9期21-24,共4页Journal of Logistics University of PAP（Medical Sciences）

基　　金：唐山市科技计划项目(17130231a)。

摘　　要：【目的】探究微创距下关节融合术对陈旧性跟骨骨折患者距骨倾斜角、骨性愈合时间及足部功能的影响。【方法】回顾性分析本院于2018年10月-2020年8月收治的92例陈旧性跟骨骨折患者临床资料,按照治疗方法不同将其分为常规组(46例)和微创组(46例)。其中常规组给予开放跟距下关节融合术,微创组给予微创距下关节融合术治疗陈旧性跟骨骨折患者。比较2组患者距骨倾斜角、术中出血量、骨性愈合时间,足部功能改善情况,疼痛指标[白细胞介素-6(IL-6)、β-内啡肽(β-EP)、P物质(SP)、前列腺素E2(PGE2)]以及并发症发生情况。【结果】与常规组比较,微创组术中出血量、骨性愈合时间明显降低(P<0.05);与手术前距骨倾斜角比较,2组术后均明显升高(P<0.05),且与常规组比较,微创组明显升高(P<0.05);与手术前血清IL-6、β-EP、SP、PGE2水平比较,2组手术后均明显降低(P<0.05),且与常规组比较,微创组明显降低(P<0.05);与常规组足部功能优良率78.26%比较,微创组95.65%明显升高(P<0.05);与常规组并发症发生率26.09%比较,微创组6.52%明显降低(P<0.05)。【结论】微创距下关节融合术用于陈旧性跟骨骨折可有效改善患者足部功能,促进骨性愈合,减轻疼痛,增大距骨倾斜角,减少并发症发生率,安全有效。【Objective】To explore the effects of minimally invasive subtalar arthrodesis on talar tilt angle,bone healing time and foot function in patients with old calcaneal fractures.【Methods】The clinical data of 92 patients with old calcaneal fractures admitted to our hospital from October 2018 to August 2020 were retrospectively analyzed.According to different treatment methods,they were divided into conventional group(46 cases)and minimally invasive group(46 cases).Among them,the conventional group was given open subtalar arthrodesis,and the minimally invasive group was given minimally invasive subtalar arthrodesis to treat patients with old calcaneal fractures.The talar tilt angle,intraoperative blood loss,bone healing time,improvement of foot function,pain indexes[interleukin-6(IL-6),β-endorphin(β-EP),P substance(SP),prostaglandin E2(PGE2)]and the occurrence of complications were compared between the two groups.【Results】Compared with the conventional group,the intraoperative blood loss and bone healing time in the minimally invasive group were significantly lower(P<0.05);compared with the talar tilt angle before surgery,that of the two groups was significantly increased after surgery(P<0.05),and compared with the conventional group,the minimally invasive group was significantly higher(P<0.05);compared with the levels of serum IL-6,β-EP,SP,and PGE2 before surgery,those of the two groups were significantly reduced after surgery(P<0.05),and compared with the conventional group,the minimally invasive group were significantly lower(P<0.05);compared with the excellent and good rate of foot function of 78.26%in the conventional group,that of 95.65%in the minimally invasive group was significantly higher(P<0.05);compared with the complication rate of 26.09%in the conventional group,that of 6.52%in the minimally invasive group was significantly lower(P<0.05).【Conclusion】Minimally invasive subtalar arthrodesis for old calcaneal fractures can effectively improve the foot function of patients,promote bone heal

关 键 词：陈旧性跟骨骨折 微创距下关节融合术 距骨倾斜角 足部功能 骨性愈合时间 

分 类 号：R683.42[医药卫生—骨科学]