跗骨窦入路空心钉内固定术在跟骨骨折中的应用效果及影响因素探讨  

Application effect and influencing factors of tarsal sinus approach hollow nail fixation in calcaneal fracture

作　　者：李西子 王培霞[1] 李沙沙 LI Xi-Zi;WANG Pei-xia;LI Sha-sha(Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院骨科,郑州450000

出　　处：《医药论坛杂志》2024年第11期1196-1200,共5页Journal of Medical Forum

摘　　要：目的分析跗骨窦入路(sinus tarsi approach,STA)空心钉内固定术治疗跟骨骨折的疗效,并分析影响治疗结果的相关因素。方法选取2022年5月至2023年6月郑州大学第一附属医院骨科收治的跟骨骨折患者120例,按手术方法不同分组,将行扩展外侧入路(extended lateral approach,ELA)钢板内固定术治疗的60例作为对照组,行STA空心钉内固定术治疗的60例作为观察组,均随访6个月,比较两组足部功能、手术相关指标、并发症发生率,并依据是否发生并发症对观察组患者进行分组,分析影响STA空心钉治疗效果的相关因素。结果观察组手术切口长度、术中出血量及切口愈合用时为(4.23±1.04)cm、(78.36±10.24)mL、(20.16±1.35)d,均少于对照组,差异有统计学意义(P<0.05);术前两组患侧AOFAS评分与Bohler角比较,差异无统计学意义(P>0.05),观察组治疗6个月AOFAS评分(83.25±4.57)分,Bohler角(30.58±4.63)°,均高于对照组(P<0.05);观察组并发症发生率25.00%,与对照组的41.67%比较,差异无统计学意义(P>0.05);60例观察组分为并发症组(15例)、无并发症组(45例),两组年龄、吸烟、Sanders分型、术前软组织肿胀情况、术后Bohler角及AOFAS评分比较,差异有统计学意义(P<0.05);对上述对比有意义指标赋值,建立回归模型,结果显示较大年龄、较高Sanders分型是跟骨骨折STA空心钉内固定治疗后发生并发症的风险因子,术后较高Bohler角则是并发症发生的保护因子(P<0.05)。结论跟骨骨折患者应用STA空心钉内固定术治疗能明显获益,不仅能提高骨折部位修复效果、促进功能康复,还能控制并发症发生概率。影响疗效及并发症发生的因素有年龄、骨折严重程度及跟骨重建程度。Objective To analyze the efficacy of sinus tarsi approach(STA)hollow nail internal fixation in the treatment of calcaneal fracture,and analyze the related factors affecting the treatment results.Methods A total of 120 patients with calcaneal fracture admitted to the Department of Orthopedics of the First Affiliated Hospital of Zhengzhou University from May 2022 to June 2023 were divided into groups according to different surgical methods.60 patients receiving extended lateral approach(ELA)plate internal fixation were selected as the control group,and 60 patients receiving STA hollow nail internal fixation were selected as the observation group.All patients were followed up for 6 months.The foot function,surgery-related indicators and complication rate of the two groups were compared,and the patients in the observation group were divided according to whether complications occurred,and the related factors affecting the treatment effect of STA hollow nail were analyzed.Results The incision length,intraoperative blood loss and wound healing time in the observation group were(4.23±1.04)cm,(78.36±10.24)mL and(20.16±1.35)d,which were all lower than those of the control group(P<0.05).The AOFAS score and Bohler Angle on the affected side of the two groups were compared before surgery(P>0.05).After 6 months of treatment,the AOFAS score and Bohler Angle of the observation group were(83.25±4.57)points and(30.58±4.63)degrees,both of which were higher than those of the control group(P<0.05).The complication rate in observation group was 25.00%,compared with 41.67%of control group(P>0.05).The 60 observation groups were divided into complication group(15 cases)and uncomplication group(45 cases).Age,smoking,Sanders classification,preoperative soft tissue swelling,postoperative Bohler Angle and postoperative AOFAS score were statustucally significant difference between the two groups(P<0.05).A regression model was established to assign values to the above comparative meaningful indicators.The results showed that older age and

关 键 词：跟骨骨折 跗骨窦入路空心钉内固定术 并发症 风险因素 

分 类 号：R687.3[医药卫生—骨科学]