跗骨窦小切口入路内固定术配合中医正骨手法治疗跟骨骨折的临床疗效评价  

Clinical Efficacy of Calcaneal Fracture Treatment with Tarsal Sinus Small Incision Internal Fixation Combined with Traditional Chinese Medicine Orthopaedic Manipulation

作　　者：巫敬文 周琦石[2] 陈信军[1] 杨林 WU Jingwen(Qingyuan Traditional Chinese Medicine Hospital,Guangdong Guangzhou 511599,China)

机构地区：[1]广州中医药大学附属清远市中医院,广东清远511599 [2]广州中医药大学第一附属医院一骨科,广东广州510405

出　　处：《河北医学》2024年第4期635-640,共6页Hebei Medicine

基　　金：广东省卫生健康行业科研项目(编号:20B200456)。

摘　　要：目的:研究跗骨窦小切口入路内固定术配合中医正骨手法治疗跟骨骨折的临床疗效。方法:以回顾性分析为法,观察对象为2018年1月至2022年6月清远市中医院的80例跟骨骨折患者,依据治疗方案不同分为两组,观察组在跗骨窦小切口入路内固定术的基础上配合中医正骨手法辅助治疗,对照组实施跗骨窦小切口入路内固定术。收集两组患者的一般资料及影像学参数,并对手术时间、术中出血量、住院时长、疼痛程度、跟骨参数、足踝功能以及并发症予以分析。结果:组间对比性别、年龄等资料,差异无统计学意义(P>0.05);术中出血量、住院时间观察组明显低于对照组(P<0.05),手术时长比较,差异无统计学意义(P>0.05);随着术后时间的延长,两组患者的VAS疼痛评分均下降,以观察组降低幅度更大,差异有统计学意义(P<0.05);两组术前Gissane角、Bohler角、Pitch角、足踝评分比较,差异无统计学意义(P>0.05);较术前,两组术后Gissane角、Bohler角、Pitch角均增大,足踝评分升高,差异有统计学意义(P<0.05);两组Gissane角、Bohler角、Pitch角、足踝评分手术前后差值比较,差异有统计学意义(P<0.05);观察组术后并发症发生率2.38%,与对照组的并发症发生率5.26%比较,差异无统计学意义(χ^(2)=1.065,P>0.05)。结论:跗骨窦小切口入路内固定术配合中医正骨手法治疗跟骨骨折患者临床疗效较好,能够配合手术进程,弥补不能充分暴露的缺点,达到良好复位的目的,并能缩短住院时间,减少术中出血量、降低疼痛程度,促进足部功能与骨折端解剖结构的恢复,且安全性较高。Objective:To investigate the clinical efficacy of calcaneal fracture treatment with tarsal sinus small incision internal fixation combined with traditional Chinese medicine orthopaedic manipulation.Meth-ods:A retrospective analysis was conducted on 80 patients with calcaneal fracture in Qingyuan Traditional Chinese Medicine Hospital from January 2018 to June 2022.According to different treatment plans,they were divided into two groups.The observation group was treated with tarsal sinus small incision internal fixation combined with traditional Chinese medicine orthopaedic manipulation,and the control group was treated with tarsal sinus small incision internal fixation.The general data and imaging parameters of the patients in the two groups were collected,and the operation time,intraoperative blood loss,length of hospital stay,pain score,calcaneal parameters,ankle function,and complications were analyzed.Results:There was no statistically significant difference in gender,age,and other data between the two groups(P>0.05).The intraoperative blood loss and length of hospital stay in the observation group were significantly lower than those in the control group(P<0.05).There was no statistically significant difference in the operation time between the two groups(P>0.05).With the extension of the postoperative time,the VAS pain scores of the patients in both groups decreased,and the observation group had a greater decrease,with a statistically significant difference(P<0.05).There was no statistically significant difference in the Gissane angle,Bohler angle,Pitch angle,and an-kle score between the two groups before surgery(P>0.05).Compared with the preoperative values,the Gis-sane angle,Bohler angle,and Pitch angle increased,and the ankle score increased in both groups after sur-gery,with a statistically significant difference(P<0.05).There was a statistically significant difference in the changes of Gissane angle,Bohler angle,Pitch angle,and ankle score before and after surgery between the two groups(P<0.05).The incid

关 键 词：跟骨骨折 跗骨窦小切口入路内固定术 中医正骨 顺势复位 加速康复 

分 类 号：R687.3[医药卫生—骨科学]