改良“八”字切口与“L”形切口入路钢板内固定术在跟骨骨折患者中的应用效果比较  

Comparison of application effects of plate internal fixation via modified“8”incision and“L”incision approaches in patients with calcaneal fractures

作　　者：侯新房 HOU Xinfang(Department of Orthopedics of Xincai County People’s Hospital,Zhumadian 463500 Henan,China)

机构地区：[1]新蔡县人民医院骨科,河南驻马店463500

出　　处：《中国民康医学》2025年第9期154-157,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较改良“八”字切口与“L”形切口入路钢板内固定术在跟骨骨折患者中的应用效果。方法:回顾性分析2021年6月至2023年6月该院收治的67例跟骨骨折患者的临床资料,依照不同切口入路将其分为研究组34例与对照组33例。研究组行改良“八”字切口入路钢板内固定术治疗,对照组行“L”型切口入路钢板内固定术治疗,比较两组手术相关指标(首次负重下床时间、骨折愈合时间、术中出血量、手术时间、切口愈合时间、住院时间)水平,手术前后跟骨影像学参数[跟骨交叉角(Gissane角)、跟骨结节关节角(Bǒhler角)、跟骨高度、跟骨宽度]水平、足踝功能[Maryland足部评分系统(MFS)、美国矫形外科足踝协会(AOFAS)]评分,以及并发症发生率。结果:两组首次负重下床时间、骨折愈合时间比较,差异均无统计学意义(P>0.05);研究组术中出血量少于对照组,手术时间、切口愈合时间、住院时间均短于对照组,差异有统计学意义(P<0.05);术后6个月,两组跟骨高度、Bǒhler角与Gissane角均大于术前,两组跟骨宽度均小于术前,但组间比较,差异无统计学意义(P>0.05);术后6个月,两组MFS、AOFAS评分均高于术前,但组间比较,差异无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:改良“八”字切口与“L”形切口入路钢板内固定术应用于跟骨骨折患者的临床疗效相当,但改良“八”字切口入路可减少术中出血量,缩短手术时间、切口愈合时间和住院时间的效果优于“L”形切口入路。Objective:To compare application effects of plate internal fixation via modified“8”incision and“L”incision approaches in patients with calcaneal fractures.Methods:The clinical data of 67 patients with calcaneal fractures admitted to this hospital from June 2021 to June 2023 were retrospectively analyzed.According to different incision approaches,they were divided into study group(34 cases)and control group(33 cases).The study group was treated with plate internal fixation via modified“8”incision approach,while the control group was treated with plate internal fixation vis“L”incision approach.The levels of operation-related indexes(first weight-bearing out-of-bed time,fracture healing time,intraoperative blood loss,operation time,incision healing time,hospitalization time),calcaneal imaging parameters[Gissane angle,Bǒhler angle,calcaneal height,calcaneal width],the foot and ankle function[Maryland foot scoring system(MFS),American Orthopedic Foot and Ankle Society(AOFAS)]scores before and after the surgery,and the incidence of complications were compared between the two groups.Results:There were no significant differences in the first weight-bearing put-of-bed time and the fracture healing time between the two groups(P>0.05).The intraoperative blood loss in the study group was less than that in the control group;the operation time,the incision healing time and the hospitalization time were shorter than those in the control group;and the differences were statistically significant(P<0.05).Six months after the surgery,the levels of calcaneal height,Bǒhler and Gissane angles of the two groups were greater than those before the surgery,and the calcaneal width levels of the two groups were less than those before the surgery,but there were no significant differences between the two groups(P>0.05).Six months after the surgery,the MFS and AOFAS scores of the two groups were higher than those before the surgery,but there were no significant differences between the two groups(P>0.05).There was no significan

关 键 词：改良“八”字切口入路 “L”形切口入路 跟骨骨折 跟骨影像学参数 足踝功能 并发症 

分 类 号：R683.4[医药卫生—骨科学]