经跗骨窦切口撬拔复位空心螺钉固定SandersⅢ型跟骨骨折  

Trans-tarsal sinus incision prying reduction with hollow screw fixation for treatment of Sanders typeⅢcalcaneal fracture

作　　者：陈文靖 余黎[1] 周敏[1] 李宗焕[1] 邓宇[1] 刘华麒 沈志达 张梦雪[1] Chen Wenjing;Yu Li;Zhou Min;Li Zonghuan;Deng Yu;Liu Huaqi;Shen Zhida;Zhang Mengxue(Department of Trauma and Microsurgery Orthopedics,Zhongnan Hospital of Wuhan University,Hubei Wuhan 430071,China)

机构地区：[1]武汉大学中南医院创伤与显微骨科,湖北武汉430071

出　　处：《足踝外科电子杂志》2024年第2期6-11,共6页Electronic Journal of Foot and Ankle Surgery

基　　金：湖北省区域科技创新专项国际科技合作项目(2023EHA043)。

摘　　要：目的探讨经跗骨窦切口撬拨复位空心螺钉固定治疗SandersⅢ型跟骨骨折的效果。方法选取2021年3月至2022年12月于武汉大学中南医院行手术治疗的72例SandersⅢ型跟骨骨折患者为研究对象,根据手术方式的不同将患者分为微创组与传统组。微创组35例采用经跗骨窦切口撬拔复位空心螺钉固定治疗,传统组37例采用传统外侧“L”形切口入路钢板内固定治疗。比较两组术后美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足功能评分、视觉模拟评分法(visual analogue scale,VAS)评分、治疗优良率、并发症发生情况、跟骨影像学参数指标、骨折愈合时间以及治疗满意度。结果在末次随访中,两组骨折均获得骨性愈合,微创组AOFAS评分高于传统组,差异有统计学意义(P<0.05),两组VAS评分、优良率、Böhler角、Gissane角、骨折愈合时间比较,差异均无统计学意义(P>0.05)。微创组切口局部并发症总发生率低于传统组,差异有统计学意义(P<0.05)。两组创伤性关节炎发生率比较,差异无统计学意义(P>0.05)。微创组治疗满意度高于传统组,差异有统计学意义(P<0.05)。结论经跗骨窦切口撬拨复位空心螺钉固定治疗SandersⅢ型跟骨骨折,患者骨折复位固定良好,切口皮肤感染及坏死发生率低。Objective To investigate the efficacy of Kirschner wire prying and hollow screw fixation in treating Sanders typeⅢcalcaneal fracture through sinus tarsi approach.Methods 72 patients with Sanders typeⅢcalcaneal fracture who underwent surgical treatment in Zhongnan Hospital of Wuhan University from March 2021 to December 2022 were selected as the study objects,and were divided into minimally invasive group and traditional group according to different surgical methods.In the minimally invasive group,35 cases were treated by prying out and reducing hollow screws through tarsal sinus incision,and in the traditional group,37 cases were treated by traditional lateral"L"incision approach plate internal fixation.Compare two groups of postoperative the American Orthopedic Foot and Ankle Society(AOFAS)after ankle-foot function score,visual analogue scale method(VAS)score,excellent and good rate of treatment,complications,calcaneal imaging parameters,fracture healing time,and treatment satisfaction.Results At the last follow-up,bone healing was achieved in both groups,and the AOFAS score in the minimally invasive group was higher than that in the traditional group,the difference was statistically significant(P<0.05).There were no statistically significant differences in VAS score,excellent and good rate,Böhler angle,Gissane angle and fracture healing time between the two groups(P>0.05).The total incidence of local incision complications in minimally invasive group was lower than that in traditional group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of traumatic arthritis between the two groups(P>0.05).Treatment satisfaction in minimally invasive group was higher than that in traditional group,and the difference was statistically significant(P<0.05).Conclusion The treatment of Sanders typeⅢcalcaneal fracture by prying and repositioning hollow screw fixation through the tarsal sinus incision has good fracture restoration and fixation,and the incidence of i

关 键 词：跟骨骨折 微创 撬拨复位 跗骨窦切口 空心螺钉固定 

分 类 号：R683.4[医药卫生—骨科学]