跗骨窦微创切口与外侧L形切口入路钢板内固定术治疗跟骨骨折患者的效果比较  

Comparison of effects of plate internal fixation through minimally invasive incision of tarsal sinus and L-shaped lateral tarsal sinus incision in treatment of calcaneal fractures

作　　者：李冰[1] LI Bing(Emergency Department of Xuchang Central Hospital Affiliated to Henan University of Science and Technology,Xuchang 461000 Henan,China)

机构地区：[1]河南科技大学附属许昌市中心医院急诊科,河南许昌461000

出　　处：《中国民康医学》2023年第11期142-145,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较跗骨窦微创切口与外侧L形切口入路内固定术治疗跟骨骨折患者的效果。方法:回顾性分析2016年10月至2020年3月该院收治的72例跟骨骨折患者的临床资料,根据手术入路方式不同将其分为观察组37例和对照组35例。观察组采用跗骨窦微创切口入路钢板内固定术治疗,对照组采用外侧L形切口入路钢板内固定术治疗,比较两组治疗优良率、手术相关指标水平,术前、术后随访12个月足踝功能指标[跟骨Bohler角、Gissane角、Maryland足部评分系统评分、踝-后足功能评分系统(AOFAS)评分]水平,以及术后12个月并发症发生率。结果:观察组治疗优良率为86.49%(32/37),高于对照组的65.71%(23/35),差异有统计学意义(P<0.05);观察组术中出血量少于对照组,切口长度和骨折愈合时间均短于对照组,差异有统计学意义(P<0.05);术后,两组Bohler角、Gissane角均大于术前,但组间比较,差异无统计学意义(P>0.05);两组Maryland足部评分系统评分、AOFAS评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率为2.70%(1/37),低于对照组的22.86%(8/35),差异有统计学意义(P<0.05)。结论:跗骨窦微创切口入路钢板内固定术治疗跟骨骨折患者可提高治疗优良率、Maryland足部评分系统评分和AOFAS评分,降低手术相关指标水平和术后并发症发生率,效果优于外侧L形切口入路钢板内固定术治疗。Objective:To compare effects of plate internal fixation through minimally invasive incision of tarsal sinus and L-shaped lateral tarsal sinus incision in treatment of calcaneal fractures.Methods:The clinical data of 72 patients with calcaneal fractures admitted to this hospital from October 2016 to March 2020 were retrospectively analyzed.According to different surgical approaches,they were divided into observation group(37 cases)and control group(35 cases).The observation group was treated with plate internal fixation through the minimally invasive incision of tarsal sinus,while the control group was treated with plate internal fixation through the lateral L-shaped incision.The excellent and good rate of treatment,the levels of surgical related indexes,the levels of ankle function indexes[calcaneal Bohler angle,Gissane angle,Maryland foot scoring system score,ankle-hindfoot function scoring system(AOFAS)score]before and 12 months after the surgery,and the incidence of complications 12 months after the surgery were compared between the two groups.Results:The excellent and good rate of treatment in the observation group was 86.49%(32/37),which was higher than 65.71%(23/35)in the control group,and the difference was statistically significant(P<0.05).The intraoperative blood loss in the observation group was less than that in the control group,the incision length and the fracture healing time were shorter than those in the control group,and the differences were statistically significant(P<0.05).After the surgery,the Bohler angle and the Gissane angle of the two groups were larger than those before the surgery,but there were no significant differences between the two groups(P>0.05).The Maryland foot scoring system scores and the AOFAS scores of the two groups were higher than those before the surgery,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of postoperative complications in the observation group was 2.70

关 键 词：跟骨骨折 跗骨窦微创切口 外侧L形切口 钢板内固定术 足踝功能 并发症 

分 类 号：R683.42[医药卫生—骨科学]