摘要
目的 探讨经跗骨窦入路切开复位内固定术(ORIF)治疗跟骨骨折的效果及对足踝功能的影响。方法 选取2021年1月至2023年10月南阳市中医院收治的84例跟骨骨折患者为研究对象。按随机数字表法分为两组,每组42例。两组均行ORIF治疗,对照组经外侧L形入路,观察组经跗骨窦入路。比较两组手术情况、疼痛评分[视觉模拟评分法(VAS)]、足踝功能[踝-后足评分系统(AOFAS)]、下肢活动能力[运动功能评定量表(FMA)]、影像学指标及并发症。结果 观察组切口长度、切口愈合时间为(6.55±1.12)cm、(13.85±1.27)d,短于对照组[(11.52±1.27)cm、(15.54±1.39)d],术中失血量为(42.62±4.63)ml,少于对照组[(75.95±7.58)ml](P<0.05)。观察组术后VAS评分为(1.22±0.23)分,低于对照组[(1.61±0.25)分],AOFAS评分、下肢FMA评分为(88.67±5.35)分、(29.58±2.76)分,高于对照组[(80.41±5.28)分、(24.42±2.53)分](P<0.05)。两组跟骨长度、Bohler角、Gissane角术前及术后比较,差异未见统计学意义(P>0.05)。观察组术后并发症少于对照组(P<0.05)。结论 经跗骨窦入路ORIF治疗跟骨骨折效果更佳,可减轻手术创伤,加快足踝功能恢复,且并发症少。
Objective To investigate the effect of transtarsal sinus approach open reduction and internal fixation(ORIF)on calcaneal fracture and the effect on foot and ankle function.Methods s Eighty-four patients with calcaneal fracture admitted to Nanyang Hospital of Traditional Chinese Medicine from January 2021 to October 2023 were selected and divided into two groups according to random number table method,with 42 cases in each group.ORIF treatment was performed in both groups.The control group underwent lateral L-shaped approach and the observation group underwent tarsal sinus approach.The surgical status,pain score[visual analog scale(VAS)],ankle function[ankle hindfoot scoring system(AOFAS)],lower limb mobility[motor function assessment scale(FMA)],imaging indexes and complications were compared between the two groups.Results S The incision length and incision healing time in the observation group were(6.55±1.12)cm and(13.85±1.27)d,which were shorter than those in the control group[(11.52±1.27)cm and(15.54±1.39)d],and the intraoperative blood loss was(42.62±4.63)ml,which was lower than that of control group[(75.95±7.58)ml](P<0.05).The VAS score of observation group was(1.22±0.23),which was lower than that of control group[(1.61±0.25)](P<0.05).The AOFAS score and lower limb FMA score were(88.67±5.35)and(29.58±2.76),which was higher than that of control group[(80.41±5.28),(24.42±2.53)](P<0.05).There was no significant difference in calcaneal length,Bohler Angle and Gissane Angle between the two groups before and after surgery(P>0.05).The postoperative complications in the observation group were less than those in the control group(P<0.05).Conclusions ORIF via tarsal sinus approach is more effective on calcaneal fracture,which can reduce surgical trauma,accelerate functional recovery of foot and ankle,and has fewer complications.
作者
李克
汪钰涵
Li Ke;Wang Yuhan(Department of Foot and Ankle Surgery,Nanyang Hospital of Traditional Chinese Medicine,Nanyang 473000,China)
出处
《临床医学》
CAS
2024年第11期16-19,共4页
Clinical Medicine
关键词
跟骨骨折
经跗骨窦入路
切开复位内固定术
切口愈合
足踝功能
Calcaneal fracture
Transtarsal sinus approach
Open reduction and internal fixation
Wound healing
Foot and ankle function
