跗骨窦微创切口治疗舌型跟骨骨折对患者伤口愈合、腓肠神经的影响
|
摘要
目的探讨跗骨窦微创切口治疗舌型跟骨骨折对患者伤口愈合、腓肠神经的影响。方法选取2013年1月～2018年1月我院收治的53例舌型跟骨骨折患者作为研究对象,按照随机数字表法分为观察组(n=28)和对照组(n=25)。对照组患者接受传统"L"形切口复位钢板螺钉内固定治疗,观察组患者接受跗骨窦微创切口松质骨螺钉+自制小钢板内固定治疗。比较两组手术相关指标、骨折愈合时间、3个月后复查情况及并发症发生情况。结果观察组的手术切口长度、手术时间及骨折愈合时间明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P<0.05);两组治疗后的跟骨长度、跟骨高度、跟骨宽度、Bohler角(跟骨结构关节角)及Gissane角(跟骨交叉角)比较,差异无统计学意义(P>0.05);观察组的并发症总发生率(3.57%)明显低于对照组(32.00%),差异有统计学意义(P<0.05)。结论采用跗骨窦微创切口治疗舌型跟骨骨折损伤,对关节面解剖结构复位具有较好的效果,手术创伤小、操作简便、骨折愈合快、并发症少,临床推广应用价值较高。
Objective To investigate the influence of minimally invasive incision of tarsal sinus on wound healing and sural nerve in the treatment of patients with linguiform calcaneus fracture. Methods A total of 53 patients with linguiform calcaneus fracture admitted to our hospital from January 2013 to January 2018 were selected as the study subjects, they were divided into observation group(n=28) and control group(n=25) according to random number table method. Patients in the control group were treated with traditional "L" incision reduction and plate and screw internal fixation, while patients in the observation group were treated with minimally invasive tarsal sinus incision cancellous bone screw and self-made small plate internal fixation. The operation related indexes, fracture healing time, review after 3 months and complications were compared between the two groups. Results The incision length, operation time and fracture healing time of the observation group were significantly shorter than those of the control group, and the amount of bleeding during the operation was significantly less than that of the control group, the differences were statistically significant(P<0.05). There were no significant differences in calcaneal length, calcaneal height, calcaneal width, Bohler angle(calcaneal joint angle) and Gissane angle(calcaneal cross angle) between the two groups after treatment(P>0.05).The total incidence of complications in the observation group(3.57%) was significantly lower than that in the control group(32.00%), and the difference was statistically significant(P<0.05). Conclusion Minimally invasive tarsal sinus incision for treatment of linguiform calcaneus fracture injury has a good effect on the reduction of articular surface anatomical structure. It has the advantages of less trauma, simple operation, quick fracture healing and fewer complications. It has a high clinical application value.
Objective To investigate the influence of minimally invasive incision of tarsal sinus on wound healing and sural nerve in the treatment of patients with linguiform calcaneus fracture. Methods A total of 53 patients with linguiform calcaneus fracture admitted to our hospital from January 2013 to January 2018 were selected as the study subjects, they were divided into observation group(n=28) and control group(n=25) according to random number table method. Patients in the control group were treated with traditional "L" incision reduction and plate and screw internal fixation, while patients in the observation group were treated with minimally invasive tarsal sinus incision cancellous bone screw and self-made small plate internal fixation. The operation related indexes, fracture healing time, review after 3 months and complications were compared between the two groups. Results The incision length, operation time and fracture healing time of the observation group were significantly shorter than those of the control group, and the amount of bleeding during the operation was significantly less than that of the control group, the differences were statistically significant(P<0.05). There were no significant differences in calcaneal length, calcaneal height, calcaneal width, Bohler angle(calcaneal joint angle) and Gissane angle(calcaneal cross angle) between the two groups after treatment(P>0.05).The total incidence of complications in the observation group(3.57%) was significantly lower than that in the control group(32.00%), and the difference was statistically significant(P<0.05). Conclusion Minimally invasive tarsal sinus incision for treatment of linguiform calcaneus fracture injury has a good effect on the reduction of articular surface anatomical structure. It has the advantages of less trauma, simple operation, quick fracture healing and fewer complications. It has a high clinical application value.
引文
[1]叶军,白龙,于志勇.经跗骨窦微创切口治疗跟骨骨折的临床疗效分析[J].中国现代医生,2017,55(29):67-69.
[2]李来峰,王辉,赵仪云,等.跗骨窦切口联合经皮置钉技术微创治疗SandersⅢ型跟骨骨折[J].中国矫形外科杂志,2015,23(20):1850-1853.
[3]黄国伟,姜雪峰,韦山.新型跗骨窦钢板内固定治疗SandersⅡ型跟骨骨折的有限元分析[J].江苏医药,2017,43(11):781-783.
[4]李伟康,周业金.经跗骨窦间隙空心钉内固定与微型锁定钢板内固定治疗跟骨骨折疗效比较[J].山东医药,2017,57(13):85-87.
[5]黎志超,薛勇.跗骨窦切口微创切开复位内固定治疗SandersⅣ型跟骨骨折[J].中国骨与关节损伤杂志,2017,32(10):1104-1105.
[6]孙伟,黄国伟,韦山,等.经跗骨窦切口空心螺钉内固定治疗舌型跟骨骨折[J].中华骨与关节外科杂志,2015,8(1):81-83.
[7]吴荣,闵继康,黄曙峰,等.跗骨窦联合外侧纵形切口与传统外侧L型切口治疗SandersⅡ型跟骨骨折的比较研究[J].创伤外科杂志,2017,19(11):834-839.
[8]施忠民,邹剑,顾文奇,等.经跗骨窦间隙与外侧“L”形切口治疗SandersⅡ型跟骨骨折的疗效比较[J].中华骨科杂志,2013,33(4):298-303.
[9]吴旻昊,孙文超,闫飞飞,等.经微创跗骨窦切口入路与传统外侧L形切口入路比较治疗跟骨骨折的Meta分析[J].中国骨伤,2017,30(12):1118-1126.
[10]林烨澎,何志明,汪志中,等.跗骨窦小切口与传统外侧L型切口内固定治疗跟骨骨折的对比研究[J].中国骨科临床与基础研究杂志,2016,8(3):152-157.
[11]王宝宝,王强,李旗,等.跗骨窦入路联合无头空心螺钉治疗关节内跟骨骨折的疗效分析[J].北京医学,2015,37(11):1064-1067.
[12]梁卫东,陈杰,曹立海,等.跗骨窦入路微创内固定治疗合并糖尿病跟骨骨折的初步报告[J].中国骨与关节损伤杂志,2015,30(4):432-433.
[13]曾会斌,林炳禄.微创跗骨窦入路内固定术在跟骨骨折中的临床应用[J].微创医学,2015,10(5):670-671.
[14]廖习如,刘忠国,陈家生,等.经跗骨窦小切口和跟骨外侧“L”型切口治疗跟骨骨折效果及并发症比较研究[J].中外医学研究,2016,14(36):31-32.
[15]肖国栋,刘国辉.跗骨窦切口联合经皮置钉技术微创治疗跟骨骨折的临床疗效分析[J].临床外科杂志,2016,24(10):783-785.
[2]李来峰,王辉,赵仪云,等.跗骨窦切口联合经皮置钉技术微创治疗SandersⅢ型跟骨骨折[J].中国矫形外科杂志,2015,23(20):1850-1853.
[3]黄国伟,姜雪峰,韦山.新型跗骨窦钢板内固定治疗SandersⅡ型跟骨骨折的有限元分析[J].江苏医药,2017,43(11):781-783.
[4]李伟康,周业金.经跗骨窦间隙空心钉内固定与微型锁定钢板内固定治疗跟骨骨折疗效比较[J].山东医药,2017,57(13):85-87.
[5]黎志超,薛勇.跗骨窦切口微创切开复位内固定治疗SandersⅣ型跟骨骨折[J].中国骨与关节损伤杂志,2017,32(10):1104-1105.
[6]孙伟,黄国伟,韦山,等.经跗骨窦切口空心螺钉内固定治疗舌型跟骨骨折[J].中华骨与关节外科杂志,2015,8(1):81-83.
[7]吴荣,闵继康,黄曙峰,等.跗骨窦联合外侧纵形切口与传统外侧L型切口治疗SandersⅡ型跟骨骨折的比较研究[J].创伤外科杂志,2017,19(11):834-839.
[8]施忠民,邹剑,顾文奇,等.经跗骨窦间隙与外侧“L”形切口治疗SandersⅡ型跟骨骨折的疗效比较[J].中华骨科杂志,2013,33(4):298-303.
[9]吴旻昊,孙文超,闫飞飞,等.经微创跗骨窦切口入路与传统外侧L形切口入路比较治疗跟骨骨折的Meta分析[J].中国骨伤,2017,30(12):1118-1126.
[10]林烨澎,何志明,汪志中,等.跗骨窦小切口与传统外侧L型切口内固定治疗跟骨骨折的对比研究[J].中国骨科临床与基础研究杂志,2016,8(3):152-157.
[11]王宝宝,王强,李旗,等.跗骨窦入路联合无头空心螺钉治疗关节内跟骨骨折的疗效分析[J].北京医学,2015,37(11):1064-1067.
[12]梁卫东,陈杰,曹立海,等.跗骨窦入路微创内固定治疗合并糖尿病跟骨骨折的初步报告[J].中国骨与关节损伤杂志,2015,30(4):432-433.
[13]曾会斌,林炳禄.微创跗骨窦入路内固定术在跟骨骨折中的临床应用[J].微创医学,2015,10(5):670-671.
[14]廖习如,刘忠国,陈家生,等.经跗骨窦小切口和跟骨外侧“L”型切口治疗跟骨骨折效果及并发症比较研究[J].中外医学研究,2016,14(36):31-32.
[15]肖国栋,刘国辉.跗骨窦切口联合经皮置钉技术微创治疗跟骨骨折的临床疗效分析[J].临床外科杂志,2016,24(10):783-785.