摘要
目的:探讨关节镜下复位联合骨科机器人导航置钉治疗SandersⅡ、Ⅲ型跟骨骨折的临床疗效。方法:前瞻性随机对照研究。纳入2019年9月—2022年1月徐州仁慈医院足踝外科SandersⅡ、Ⅲ型跟骨骨折患者60例,其中男47例、女13例,年龄15~58(39.3±10.8)岁;左足31例、右足29例。按数字表法随机分为2组:观察组30例采用关节镜下跟骨关节内骨折复位、机器人导航置入空心钉,对照组30例采用传统的跟骨外侧“L”形切口,跟骨骨折复位钢板内固定。比较2组患者手术住院时间、切口长度、术中出血量、骨折愈合时间、手术时间、术前及末次随访时跟骨Gissane角和Bohler角、美国足踝外科协会(AOFAS)踝-后足功能评分、疼痛视觉模拟评分法(VAS)评分及术后并发症发生率等差异。结果:60例患者手术顺利,术后均获随访12~16(13.63±1.26)个月。2组患者年龄、随访时间、性别、损伤侧别、致伤原因、Bohler角和Gissane角等基线资料比较,差异均无统计学意义(P值均>0.05)。观察组住院时间、切口长度、术中出血量、VAS评分、并发症发生率等观察指标分别为5.5(5.0,6.0)d、39(35,40)mm、20(15,25)mL、0(0,1)分、13.3%(4/30),均小于对照组的9.0(8.0,10.5)d、120.00(115,125)mm、45(35,50)mL、2(1,2)分、36.7%(11/30);观察组手术时间、AOFAS评分分别为90(80,95)min、92.0(90.0,93.0)分,均大于对照组的60(50,75)min、90.0(89.7,91.3)分:2组比较差异均有统计学意义(Z=6.61、6.70、6.69、4.88,χ^(2)=4.35,Z=8.51、2.77,P值均<0.05)。与对照组比较,观察组骨折愈合时间、末次随访时的Gissane角和Bohler角均无明显变化,差异均无统计学意义(P值均>0.05)。观察组患者切口均一期愈合,其中2例患者术后3个月出现距下关节疼痛、2例患者术后2个月出现腓骨肌激惹症状;对照组中,切口一期愈合25例,二期愈合5例(2例患者术后1周皮肤切口坏死、3例患者术后第3日切口皮缘坏死),另有
Objective This study aimed to investigate the clinical efficacy of arthroscopic fracture reduction combined with orthopedic robot navigation screw placement in the treatment of SandersⅡorⅢcalcaneal fractures.Methods This was a prospective randomized controlled study.Sixty patients with Sanders typeⅡorⅢcalcaneal fractures in the Department of Foot and Ankle Surgery of Xuzhou Renci Hospital from September 2019 to January 2022,were included,including 47 males and 13 females,aged 15-58(39.3±10.8)years.Among them,31 cases of left foot and 29 cases of right foot,and all patients were randomly divided into experimental group(n=30)and control group(n=30)via numerical table method.The experimental group was treated with arthroscopic reduction of calcaneal intra-articular fracture and placement of hollow screws by robot navigation.The control group was treated with the traditional"L"-shaped incision on the lateral side of the calcaneus and internal fixation of calcaneal fracture reduction plate.The hospitalization time,incision length,intraoperative blood loss,fracture healing time,operation time,and Gissane and Bohler angles before operation and at the last follow-up were compared between the two groups.The differences in American Orthopedic Foot and Ankle Society(AOFAS)ankle hindfoot scale,VAS score,and incidence of postoperative complications were compared between the two groups.Results Surgery was successful in 60 patients,and the patients were followed up for 12-16(13.63±1.26)months.No statistically significant difference was found in general information,such as age,follow-up time,sex,injury side,cause of injury,and Gissane angle,between the two groups(all P values>0.05).The observation indicators of hospitalization time,incision length,intraoperative bleeding,VAS,and incidence of complications in the experimental group were 5.5(5.0,6.0)d,39(35,40)mm,20(15,25)mL,0(0,1)score,and 13.3%(4/30),respectively,which were lower than those in the control group of 9.0(8.0,10.5)d,120(115,125)mm,45(35,50)mL,2(1,2)score,a
作者
徐明亮
陈国梁
袁罕
黎仁龙
李林
陈景
石荣剑
Xu Mingliang;Chen Guoliang;Yuan Han;Li Renlong;Li Lin;Chen Jing;Shi Rongjian(Department of Foot and Ankle Surgery,Xuzhou Renci Hospital,Xuzhou 221004,China)
出处
《中华解剖与临床杂志》
2024年第8期503-509,共7页
Chinese Journal of Anatomy and Clinics
基金
徐州市重点研发计划(社会发展)(20220621)。
关键词
跟骨
骨折
骨折固定术
内
关节镜检查
机器人导航
置钉
微创手术
Calcaneal
Fracture
Fracture fixation,internal
Arthroscopy
Robot navigation
Nailing
Microtraumatic operation
