跗骨窦小切口与经外侧“L”形切口术对跟骨骨折患者的疗效  

Efficacy of a small incision for tarsal sinus approach versus an L-shape incision on the lateral approach on calcaneal fracture and their influence on recovery of foot function

作　　者：张磊[1] 王宏[1] 张小伟[1] 孟位明 赵志江[1] ZHANG Lei;WANG Hong;ZHANG Xiaowei(Second Department of Orthopedics,Zhuozhou City Hospital,Hebei,Zhuozhou 072750,China)

机构地区：[1]河北省涿州市医院骨外二科,072750

出　　处：《河北医药》2024年第15期2295-2299,共5页Hebei Medical Journal

摘　　要：目的 比较跗骨窦小切口与经外侧“L”形切口术治疗跟骨骨折的疗效及对足功能恢复情况的影响。方法 研究对象选取2020年10月至2022年10月收治的跟骨骨折患者88例,按照手术方法分为对照组43例,研究组45例,对照组采用经外侧“L”形切口术,研究组采用跗骨窦小切口手术。检测比较2组手术情况及并发症发生情况、足功能、跟骨解剖结构、骨代谢、炎性因子、应激反应指标水平。结果 与对照组比较,研究组术后引流量、术中出血量较少,手术、住院及骨折愈合时间较短,并发症发生率较低(P<0.05)。与术前比较,术后3个月2组AOFAS评分、Bohler角、Gissane角、跟骨长度、跟骨高度、P1NP、骨特异性碱性磷酸酶(BALP)水平升高,且研究组高于对照组,抗酒石酸酸性磷酸酶(TRAP)、环磷酰胺(CTX)水平降低,且研究组低于对照组(P<0.05)。与术前比较,术后3 d 2组CRP、IL-6、MDA水平升高,但研究组低于对照组,SOD水平降低,但研究组高于对照组(P<0.05)。结论 跗骨窦小切口术治疗跟骨骨折效果理想,可减少手术创伤,减轻炎症及应激反应,且可促进术后足功能、骨代谢恢复,并发症少。Objective To compare the efficacy of a small incision for tarsal sinus approach versus an L-shape incision on the lateral approach for calcaneal fracture and their influence on recovery of foot function.Methods A total of 88 patients with calcaneal fractures admitted to our hospital from October 2020 to October 2022 were recruited.They were assigned into the control group(n=43) and study group(n=45) according to surgical methods.An L-shape incision on the lateral approach was adopted in the control group,and a small incision for tarsal sinus approach was used in the study group.The operation conditions and complications,foot function,calcaneal anatomical structure,bone metabolism,inflammatory factors and stress response were compared between groups.Results Compared with those of the control group,patients in the study group had significantly less postoperative drainage volume and intraoperative blood loss,and shorter operation time,length of stay and fracture healing time,and lower complication rate(P<0.05).Compared with pre-operation levels,the American Orthopaedic Foot and Ankle Society(AOFAS) score,Bohler angle,Gissane angle,calcaneal length,calcaneal height,Procollagen Type I Intact N-terminal Propeptide(P1NP) and bone alkaline phosphatase(BALP) levels were significantly elevated at 3 months postoperatively in both groups,which were significantly higher in the study group than in the control group(P<0.05).Tartrate-resistant acid phosphatase(TRAP) and cyclophosphamide(CTX) were significantly reduced at 3 months postoperatively than preoperative levels,and they were significantly lower in the study group than control group(P<0.05).Compared with the pre-operation levels,C-reactive protein(CRP),interleukin 6(IL-6) and malondialdehyde(MDA) at 3 days postoperatively were significantly elevated,which were significantly lower in the study group than those of control group(P<0.05).Superoxide dismutase(SOD) level at 3 days postoperatively was significantly lower than preoperative level,and it was significantly higher i

关 键 词：跟骨骨折 足功能 跗骨窦小切口 经外侧“L”形切口术 

分 类 号：R683.42[医药卫生—骨科学]