摘要
目的探讨跗骨窦“八”字切口入路治疗跟骨骨折的疗效及对踝关节功能的影响。方法2014年3月~2017年5月我院手术治疗跟骨骨折患者46例,按随机数字表分为观察组和对照组,各23例,分别采用跗骨窦“八”字切口入路钢板内固定和传统“L”形切口入路钢板内固定。比较两组患者手术指标、术后并发症情况;随访 2年,观察两组患者踝关节功能恢复情况。结果两组患者手术时间、术后住院时间及骨折愈合时间比较均无统计学差异(P>0.05),但观察组患者术中出血量低于对照组,差异有统计学意义(P<0.05)。末次随访时两组B hler角、Gissane角比较无统计学差异(P>0.05)。观察组Maryland评分和AOFAS评分优良率高于对照组,差异均有统计学意义(P<0.05)。观察组切口感染2例,骨折延迟愈合1例,并发症发生率为13.04%;对照组切口感染1例,骨折延迟愈合3例,皮肤坏死1例,神经/肌腱损伤2例,并发症发生率为30.43%;两组近期并发症率比较,观察组低于对照组,差异具有统计学意义(13.04% vs. 17.39%,P<0.05)。末次随访复查X线/CT,两组患者在关节面不平整、骨不连、后足对位欠佳等远期并发症比较,差异均无统计学意义(P>0.05)。结论跗骨窦“八”字切口入路治疗跟骨骨折疗效显著,能够有效减少术中出血量,降低近期并发症率,改善足踝关节功能。
Objective To explore the effect of the "/\"-shape incision of the tarsal sinus approach for the treatment of calcaneal fractures. Methods Forty-six patients with open calcaneal fractures in our hospital from March 2014 to May 2017 were enrolled and divided into the observation group and the control group according to the random number table, with 23 cases for each. The surgery of internal fixation of locking plate was performed with "/\"-shape incision of sinus tarsi approach in the observation group and the traditional "L"-shape incision in the control group. The peri-operative surgical indexes and postoperative complications were compared between the two groups. After 2 years of follow-up, the ankle joints function of the two groups was observed and evaluated. Results There was no significant difference in the operation time, postoperative hospital stay and fracture healing time between the two groups(P>0.05). The intra-operative blood loss volume was lower in the observation group than that in the control group(P<0.05). At the last follow-up, there was no statistical difference in both Bohler angle and Gissane angle between the two groups(P>0.05), but the Maryland scores and the AOFAS excellence rate of the observation group were higher than those of the control group, and the differences were statistically(P<0.05). There were 2 cases of wound infection and 1 case of delayed union in the observation group, whereas 1 case of wound infection, 3 cases of delayed union, 1 case of skin necrosis and 2 cases of nerve-tendon injuries in the control group. The short-term complication rate was obviously lower in the observation group than the control group,and the difference was statistically( 13.04% vs.30.43%,P<0.05). There were no significant differences in long-term complications of uneven joint surface,nonunion and poor hind foot between the two groups by X-ray/CT( P>0.05). Conclusion The internal fixation of locking plate with "/\ " incision of thet ar sinus approach is effective for calcaneal fracture,which can ef
作者
王涛
马文校
李庆
WANG Tao;MA Wen-xiao;LI Qing(Department of Orthopaedics,Beijing Fengtai You Anmen Hospital,Beijing 100069,China)
出处
《中国现代手术学杂志》
2019年第3期206-210,共5页
Chinese Journal of Modern Operative Surgery
关键词
切口入路
跟骨骨折
足踝关节功能
incision approach
calcaneal fractures
foot-ankle function
