经跗骨窦切口入路治疗Sanders II、III型跟骨骨折的疗效分析

Efficacy analysis on internal fixation of through sinus tarsi approach and conventional lateral L shape approach

关键词:  跟骨骨折  跗骨窦入路  内固定

Key words:  calcaneal fracture  surgical approach  internal fixation

摘要:

目的　对比分析经跗骨窦入路及传统外侧L型扩展入路治疗跟骨Sanders II、III型跟骨骨折的疗效。方法　将2014年12月至2016年5月入院治疗并符合标准的47例跟骨骨折患者根据手术入路分为两组（传统外侧L切口入路组25例和跗骨窦切口入路组22例）。比较两组患者的手术时间、住院时间、愈合时间、术后随访功能及并发症的发生情况，并对术前术后Bohler角及Gissane角的大小进行测量。术后随访1～18个月，采用AOFAS评分评价足部功能。结果　传统外侧L切口入路组较跗骨窦切口入路组患者手术时间更长(P<0.05)；两组在骨折愈合时间、AOFAS评分、术后Bohler及Gissane角恢复等方面差异无显著性意义(P>0.05)。结论　与传统外侧L切口入路对比，经跗骨窦切口入路治疗Sanders II、III型跟骨骨折可以取得较满意的临床结果，具有一定的优势，但需严格掌握适应证，术者需有传统术式经验积累。

Abstract:

ObjectiveTo compare and analyze the curative efficacy of internal fixation of Sanders type II & III calcaneal fractures through sinus tarsi approach and conventional lateral L shape approach.MethodsForty-five cases of Sanders type II & III calcaneal fractures between December of 2014 and May of 2016 were enrolled and divided into groups A (conventional lateral L shape approach: 25 cases) and B (sinus tarsi approach: 22 cases). The operation time, hospital stay, healing time, postoperative follow-up, and complications were compared and analyzed. The preoperative & postoperative angle of Bohler and Gissane were measured and analyzed as well. The patients were followed up at 1, 3, 6, 12, and 18 month.ResultsThe conventional laterel L shape approach got a longer operation time than the sinus tarsi one (P<0.05). There are no significant differences between the two grasps in healing time. AOFAS scores, angle of Bohler and Gissane of post-operation(P>0.05). ConclusionCompared with the conventional lateral L shape approach, the Sanders type II & III calcaneal fractures treated by sinus tarsi approach got satisfied clinical results, with a shorter operation time and low skin complications. But surgeon need to grasp the indications strictly and should have the experience of traditional operation.