基于下肢生物力学评估经皮微创空心螺钉内固定治疗跟骨骨折的临床研究  

Clinical study on percutaneous minimally invasive hollow screw internal fixation for the treatment of calcaneus bone fractures based on lower limb biomechanical evaluation

作　　者：邓瑞晨 肖洪岩 魏新运[1] 杨伟胤[1] 谢云岗 Deng Ruichen;Xiao Hongyan;Wei Xinyun;Yang Weiyin;Xie Yungang(Department of Orthopedics,the Second People's Hospital of Hengshui,Hengshui 053000,China;Department of Surgery,Hengshui Traditional Chinese Medicine Hospital,Hengshui,053000,China)

机构地区：[1]衡水市第二人民医院骨科,053000 [2]衡水市中医医院外科,053000

出　　处：《中华老年骨科与康复电子杂志》2025年第1期46-51,共6页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：衡水市科技计划项目(2020014048Z)。

摘　　要：目的研究经皮微创空心螺钉内固定治疗跟骨骨折的临床疗效及对患者下肢生物力学的影响。方法前瞻性收集2020年2月至2022年1月在我院接受治疗的94例跟骨骨折患者(SandersⅡ,Ⅲ型),男55例,女39例,年龄22~68岁,平均(46.12±6.19)岁。按照随机数表法进行分组,对照组47例给予切开复位钢板内固定治疗,研究组47例给予经皮微创空心螺钉内固定治疗。比较两组围术期相关指标、手术前后影像学参数、生物力学指标、足踝功能、并发症及生活质量。结果94例患者均获得随访,随访时间(4.9±0.4)个月。研究组术中失血量较对照组少,而手术时长、切口长度、住院及骨折愈合时间较对照组短(P<0.05)。两组术后3个月Bohler角、Gissane角、WHOQOL-BREF各项评分均显著升高,而跟骨宽度、胫骨扭转、股骨内旋、前足外翻、股骨外旋显著降低(P<0.05);术后3个月,研究组Bohler角、Gissane角、WHOQOL-BREF各项评分比对照组高,跟骨宽度、胫骨扭转、股骨内旋、前足外翻、股骨外旋比对照组低(P<0.05)。研究组足踝功能优良率(95.74%)较对照组(78.72%)高(P<0.05)。研究组并发症发生率(4.26%)较对照组(19.15%)低(P<0.05)。两组术后3个月WHOQOL-BREF中社会关系、环境、心里、生理各项评分均显著升高,且研究组WHOQOL-BREF各项评分比对照组高(P<0.05)。说明研究组生活质量更高。结论经皮微创空心螺钉内固定治疗跟骨骨折疗效确切,可有效促进患者足踝功能恢复,改善下肢生物力学,且并发症少,恢复快,有助于改善生活质量。Objective To study the clinical efficacy of percutaneous minimally invasive hollow screw internal fixation for the treatment of calcaneus bone fractures and its impact on lower limb biomechanics in patients.Methods 94 patients with calcaneus bone fractures who were treated in our hospital from February 2020 to January 2022 were selected and divided into groups using a random number table method.The control group consisted of 47 patients who received open reduction and internal fixation with steel plates,while the study group consisted of 47 patients who received percutaneous minimally invasive hollow screw internal fixation.Compare the perioperative related indicators,preoperative and postoperative imaging parameters,biomechanical indicators,ankle function,complications,and quality of life between the two groups.Results The study group had less intraoperative blood loss compared to the control group,while the surgical duration,incision length,hospitalization,and fracture healing time were shorter than the control group(P<0.05).At 3 months after surgery,the scores of Bohler angle,Gissane angle,and WHOQOL-BREF in both groups significantly increased,while the calcaneal width,tibial torsion,femoral internal rotation,forefoot valgus,and femoral external rotation significantly decreased(P<0.05);3 months after surgery,the scores of Bohler angle,Gissane angle,and WHOQOL-BREF in the study group were higher than those in the control group,while the calcaneal width,tibial torsion,femoral internal rotation,forefoot valgus,and femoral external rotation were lower than those in the control group(P<0.05).The excellent and good rate of ankle function in the study group(95.74%)was higher than that in the control group(78.72%)(P<0.05).The incidence of complications in the study group(4.26%)was lower than that in the control group(19.15%)(P<0.05).Conclusion Percutaneous minimally invasive hollow screw internal fixation for the treatment of calcaneus bone fractures has a definite therapeutic effect,which can effectively promote the

关 键 词：跟骨骨折 经皮微创空心螺钉内固定 生物力学 足踝功能 并发症 

分 类 号：R68[医药卫生—骨科学]