经皮撑开复位联合跗骨窦入路空心钉与经皮撬拨复位空心钉治疗跟骨关节内骨折疗效比较  

Comparison of the Effect of Percutaneous Distraction Reduction Combined with Tarsal Sinus Approach and Percutaneous Prying Reduction of Hollow Nail in the Treatment of Calcaneal Intra-articular Fractures

作　　者：肖松[1] 王凤雄 叶琦 陈高峰[1] 邹文选 XIAO Song;WANG Fengxiong;YE Qi;CHEN Gaofeng;ZOU Wenxuan(Department of hand and foot surgery,Xiamen Third Hospital,Xiamen 361100,China)

机构地区：[1]厦门市第三医院手足外科,福建厦门361100

出　　处：《中国医药指南》2022年第28期76-78,82,共4页Guide of China Medicine

摘　　要：目的 分析经皮撑开复位联合跗骨窦入路空心螺钉内固定与经皮撬拨复位空心钉内固定治疗跟骨关节内骨折的疗效对比。方法 选取2019年1月至2021年12月我院收治的40例跟骨关节内骨折患者为研究对象,依据患者的手术方式将其分入观察组(20例)和对照组(20例),对照组患者采用经皮撬拨复位空心钉内固定治疗,观察组患者采用经皮撑开技术合联合跗骨窦入路空心钉内固定治疗。比较两组平均手术时间、术中出血量、AOFAS评分、B?hler角及Gissane角改善情况、并发症发生率、VAS评分、生活质量评分。结果 观察组平均手术时间明显短于对照组,术中出血量多于对照组,AOFAS评分高于对照组(均P <0.05)。B?hler角、Gissane角改善情况优于对照组(P <0.05)。观察组并发症发生率明显低于对照组,生活质量评分明显优于对照组,VAS评分改善情况明显优于对照组(P均<0.05)。结论 经皮撑开复位技术联合跗骨窦入路空心钉内固定治疗跟骨关节内骨折具有良好的临床效果,优于单纯经皮撬拨复位空心钉内固定治疗。Objective To compare the efficacy of percutaneous distraction reduction combined with tarsal sinus approach and percutaneous prying reduction and hollow screw fixation in the treatment of intra-articular calcaneal fractures. Methods 40 patients with intra-articular calcaneal fractures admitted to our hospital from January 2019 to December 2021 were selected as the research objects. According to the surgical methods, the patients were divided into observation group(20 cases) and control group(20 cases). The control group was treated with percutaneous prying reduction and hollow screw internal fixation. Observation group was treated with percutaneous distraction technique combined with tarsal sinus approach with hollow nail internal fixation. The mean operation time, intraoperative blood loss, improvement of B?hler’s Angle and Gissane Angle, complication rate, VAS score and quality of life score were compared between the two groups. Results The average operation time of the observation group was significantly shorter than that of the control group, the amount of intraoperative blood loss was more than that of the control group, AOFAS score was significantly higher than that of the control group(all P<0.05). The B?hler Angle and Gissane Angle in the obseration group were better than those of the control group(P<0.05). The incidence of complications in the obseration group was significantly lower than that of the control group, quality of life score was significantly better than that of the control group, and VAS score was significantly improved before and after surgery(all P<0.05). Conclusion Percutaneous distraction technique combined with tarsal distraction approach has good clinical effect in the treatment of intra-articular calcaneal fractures, and is superior to the single percutaneous prying reduction and cannular nail fixation.

关 键 词：跟骨骨折 经皮撬拨复位 跗骨窦入路 经皮撑开复位 内固定 

分 类 号：R681.42[医药卫生—骨科学]