距下关节镜结合术中X线透视微创复位螺钉内固定治疗Sanders Ⅱ、Ⅲ型跟骨骨折的疗效分析  

The effect of subtalar arthroscopy combined with fluoroscopy in the minimally invasive treatment of Sanders Ⅱ and Ⅲ calcaneal fractures

作　　者：闫荣亮[1] 高岩[2] 曹立海[1] 王良[1] 刘洪达[2] 杨越 陈江华[2] 朱鹏飞[2] 赵国志[2] YAN Rong-liang;GAO Yan;CAO Li-hai;WANG Liang;LIU Hong-da;YANG Yue;CHEN Jiang-hua;ZHU Peng-fei;ZHAO Guo-zhi(Department of Foot and Ankle Surgery,The Second Hospital of Tangshan,Tangshan,Hebei,063015,China)

机构地区：[1]唐山市第二医院足踝外一科,河北省063015 [2]唐山市第二医院足踝外二科,河北省063015 [3]唐山市工人医院骨一科,河北省063000

出　　处：《中国骨与关节杂志》2024年第2期93-99,共7页Chinese Journal of Bone and Joint

基　　金：河北省2019年度医学科学课题研究计划(20191518)。

摘　　要：目的观察距下关节镜结合术中X线透视微创复位螺钉内固定治疗跟骨Sanders Ⅱ、Ⅲ型骨折的效果。方法回顾分析2019年1月至2022年4月,本院足踝外科收治的128例跟骨Sanders Ⅱ、Ⅲ型骨折患者。根据手术方式分为关节镜组(距下关节镜辅助结合术中X线透视微创复位螺钉内固定)58例,对照组(传统L形切口行切开复位钢板内固定术)70例。比较两组切口长度、出血量、伤口并发症、手术时间、骨折愈合时间、术后1年美国矫形外科足踝协会(American Orthopedic Foot and Ankle Association,AOFAS)评分,疼痛视觉模拟评分(visual analog score,VAS)。结果切口长度:关节镜组(3.05±0.91)cm小于对照组(11.63±1.64)cm,差异有统计学意义(P<0.05);出血量:关节镜组(20.69±7.34)ml小于对照组(227.07±92.37)ml,差异有统计学意义(P<0.05);手术时间:关节镜组(99.31±14.70)min长于对照组(63.29±8.55)min,差异有统计学意义(P<0.05);切口并发症发生率:关节镜组(5.97%)小于对照组(20.0%),差异有统计学意义(P<0.05);骨折愈合时间:关节镜组(8.72±1.10)周短于对照组(11.06±1.33)周,差异有统计学意义(P<0.05);术后1年AOFAS评分:关节镜组(89.07±4.045)分,高于对照组(81.09±12.32)分,差异有统计学意义(P<0.05);术后1年VAS评分:关节镜组(1.74±1.26)分,低于对照组(2.91±1.29)分,差异有统计学意义(P<0.05)。结论采用距下关节镜结合术中X线透视微创复位螺钉内固定治疗Sanders Ⅱ、Ⅲ型跟骨骨折具有切口小,出血量及伤口并发症少,愈合快等优点,可达到良好的复位固定,治疗效果满意。Objective To observe the effect of subtalar arthroscope combined with fluoroscopy in the minimally invasive treatment of Sanders Ⅱ and Ⅲ calcaneal fractures.Methods A total of 128 patients with Sanders Ⅱ and Ⅲ calcaneal fractures admitted to Department of Foot and Ankle,Tangshan The Second Hospital from Jan.2019to Apr.2022 were selected as research objects.The patients were divided into two groups according to the operation performed.Arthroscopy group:58 cases,subtalar arthroscope assisted with the internal fixation of the cannulation with minimally incision.Control group:70 cases,internal fixation of the bone plate with conventional lateral L-shaped incision.Surgical incision length,intraoperative blood loss,wound complications,operation time,fracture healing time and AOFAS score and pain VAS score one year postoperatively were compared between the two groups.Results The surgical incision of the arthroscopy group(3.05±0.91)cm was shorter than that of the control group(11.63±1.64)cm,and the differences were statistically significant(P<0.05).The blood loss of the arthroscopy group(20.69±7.34)ml was less than that of the control group(227.07±92.37)ml,and the differences were statistically significant(P<0.05).The operation time of the arthroscopy group(99.31±14.70)min was longer than that of the control group(63.29±8.55)min,and the differences were statistically significant(P<0.05).The fracture healing time of the arthroscopic group(8.72±1.10)w was less than that of the control group(11.06±1.33)w,and the differences were statistically significant(P<0.05).The AOFAS score of the arthroscopic group at 1 year follow-up(89.07±4.045)was higher than that of the control group(81.09±12.32),and the differences were statistically significant(P<0.05).The VAS score of the arthroscopic group at 1 year follow-up(1.74±1.26)was higher than that of the control group(2.91±1.29),and the differences were statistically significant(P<0.05).Conclusions Subtalar arthroscope combined with fluoroscopy in the minimally inva

关 键 词：距下关节 关节镜 跟骨 骨折固定术 内 

分 类 号：R683.4[医药卫生—骨科学]