L形切口合并外踝后小切口治疗跟骨关节内骨折合并腓骨肌腱脱位  

Dual-incision approach for treatment of intra-articular calcaneal fractures associated with peroneal tendon dislocation

作　　者：花献福 郭建立 李俊 尚林[2] HUA Xian-fu;CUO Jian-li;LI Jun;SHANFG Lin(Department of Orthopedics,Jinshui District General Hospital of Zhengzhou,Zhengzhou 450003,China;Department of Podiadry,Zhengzhou Orthopaedic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州市金水区总医院骨科,郑州450003 [2]郑州市骨科医院足踝外科,郑州450052

出　　处：《医药论坛杂志》2024年第6期645-648,共4页Journal of Medical Forum

摘　　要：目的分析L形切口合并外踝后小切口治疗跟骨关节内骨折合并腓骨肌腱脱位手术疗效。方法对郑州市金水区总医院骨科和郑州市骨科医院足踝外科自2018年1月至2022年2月所收治的17例跟骨关节内骨折合并腓骨肌腱脱位的患者手术资料进行回顾性分析,其中男10例,女7例;左足9例,右足8例;年龄26~50岁,平均35.1岁。采取L形切口复位固定跟骨关节内骨折,在外踝后小切口修复腓骨肌上支持带。分别通过疼痛视觉模拟评分(Visual Analogue Scale,VAS)和美国足踝外科学会(American Orthopedic Foot and Ankle Society,AOFAS)评分来评价手术疗效。结果17例患者获得12~18个月完全随访,平均14.2个月。所有切口顺利愈合,无1例患者发生切口皮肤坏死、感染,无复位丢失、腓肠神经受损、腓骨肌腱炎等。末次随访时:VAS评分为1~3分,平均1.6分,AOFAS评分为78~92分,平均88.6分,随访中2例X线检查显示有距下关节炎表现,但末次随访时患者并无明显症状。结论对于跟骨关节内骨折合并腓骨肌腱脱位,采取L形切口合并外踝后小切口进行治疗,手术风险低,并发症少,效果确切。Objective To investigate the effectiveness of dual-incision approach for treatment of intra-articular calcaneal fractures associated with peroneal tendon dislocation.Methods Totally 17 intra-articular calcaneal fractures associated with peroneal tendon dislocation who reduction of the fracture and repair ligament were reviewed during January 2018 to February 2022.There were 10 males and 7 females,with an average age of 35.1 years(26-50 years).An L-shaped incision for reduction and fixation of intra-articular calcaneal fractures,and repairing the torn superior peroneal retinaculum through a small incision on the posterior side of the lateral malleolus.The AOFAS score and VAS score were adopted to evaluate the postoperative functions of the ankle.Results All 17 patients were followed up for 12-18 months with an average of 14.2 months.All incisions healed naturally.The sensory simulation score(VAS)was 1-3 points,with an average of 1.6 points.The foot and ankle score(AOFAS HA score)was 78-92 points,with an average of 88.6 points.2 cases suffered from subtalar arthritis,but no pain.Conclusion The dual-incision was used for intra-articular calcaneal fractures associated with peroneal tendon dislocation had low risk,few complications and definite effect.

关 键 词：跟骨 骨折 骨折固定术 腓骨肌腱 脱位 修复 

分 类 号：R683.42[医药卫生—骨科学]