跗骨窦小切口结合手法整复和跟骨外侧L型切口治疗跟骨关节内骨折的临床疗效
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摘要
目的探索跗骨窦小切口结合手法整复和跟骨外侧L型切口治疗跟骨关节内骨折的临床疗效。方法方便选取2017年4月—2018年4月期间该院跟骨关节内骨折60例患者(实施奇偶数分组模式),对照组的30例患者进行跟骨外侧L型切口治疗,观察组的30例患者进行跗骨窦小切口结合手法整复治疗,随后对比两组Bohlers角差值、跟骨中部宽度差值、Gissane角差值、切口长度、并发症发生率、骨折愈合时间、术中出血量、手术时间。结果观察组骨折愈合时间(7.45±1.33)周、术中出血量(25.78±2.61)mL、手术时间(61.48±3.22)min、切口长度(4.85±1.33)cm、并发症发生率(3.33%)、Gissane角差值(121.15±6.94)°、Bohlers角差值(31.28±3.55)°、跟骨中部宽度差值(26.38±3.23)mm、Kofoed评分(92.45±2.35)分、Maryland评分(93.16±2.41)分、优良率(96.67%)均优于对照组(t=3.235 5、31.973 9、15.013 7、12.320 3、9.016 7、t=5.514 8、11.348 2、13.344 0,56.258 4、15.423 5,χ2=10.258 2;P<0.05)。结论对跟骨关节内骨折患者实施跗骨窦小切口结合手法整复效果显著。
Objective To investigate the clinical effect of small incision of the sinus sinus combined with manual manipulation and lateral incision of the calcaneus for the treatment of intra-articular calcaneal fractures. Methods 60 patients with intra-articular fractures of the calcaneus were enrolled in our hospital from April 22, 2017 to April 22, 2018. The patients in the control group were treated with L-shaped incision of the lateral calcaneal. 30 patients in the observation group underwent small incision of the sacral sinus combined with manual manipulation, and then compared the difference between the two groups of Bohlers angle, the width of the middle part of the calcaneus, the difference of the Gissane angle, the length of the incision, the incidence of complications, the time of fracture healing, The amount of intraoperative blood loss and operation time. Results The fracture healing time of the observation group was(7.45±1.33) weeks, intraoperative blood loss(25.78±2.61)mL, operation time(61.48±3.22) min, incision length(4.85±1.33) cm, and complication rate(3.33%), Gissane angle difference(121.15±6.94)°, Bohlers angle difference(31.28±3.55)°, middle calcane width difference(26.38±3.23)mm,Kofoed score(92.45±2.35)points, Maryland score(93.16±2.41)points, the excellent and good rate(96.67%) were better than the control group(t=3.235 5, 31.973 9, 15.013 7, 12.320 3;χ2=9.016 7,t=5.514 8, 11.348 2, 13.344 0, 56.258 4, 15.423 5;χ2=10.258 2; P<0.05). Conclusion In the treatment of patients with intra-articular calcaneal fractures, the small incision of the sacral sinus combined with manual manipulation is effective.
Objective To investigate the clinical effect of small incision of the sinus sinus combined with manual manipulation and lateral incision of the calcaneus for the treatment of intra-articular calcaneal fractures. Methods 60 patients with intra-articular fractures of the calcaneus were enrolled in our hospital from April 22, 2017 to April 22, 2018. The patients in the control group were treated with L-shaped incision of the lateral calcaneal. 30 patients in the observation group underwent small incision of the sacral sinus combined with manual manipulation, and then compared the difference between the two groups of Bohlers angle, the width of the middle part of the calcaneus, the difference of the Gissane angle, the length of the incision, the incidence of complications, the time of fracture healing, The amount of intraoperative blood loss and operation time. Results The fracture healing time of the observation group was(7.45±1.33) weeks, intraoperative blood loss(25.78±2.61)mL, operation time(61.48±3.22) min, incision length(4.85±1.33) cm, and complication rate(3.33%), Gissane angle difference(121.15±6.94)°, Bohlers angle difference(31.28±3.55)°, middle calcane width difference(26.38±3.23)mm,Kofoed score(92.45±2.35)points, Maryland score(93.16±2.41)points, the excellent and good rate(96.67%) were better than the control group(t=3.235 5, 31.973 9, 15.013 7, 12.320 3;χ2=9.016 7,t=5.514 8, 11.348 2, 13.344 0, 56.258 4, 15.423 5;χ2=10.258 2; P<0.05). Conclusion In the treatment of patients with intra-articular calcaneal fractures, the small incision of the sacral sinus combined with manual manipulation is effective.
引文
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[8]白洪涛,王硕磊,谢昆,等.跗骨窦联合跟腱旁纵行切口与外侧L型切口行钢板内固定治疗跟骨骨折疗效比较[J].中国临床研究, 2018, 31(4):86-88.
[9]陈燕才.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[J].牡丹江医学院学报, 2017, 38(4):53-55.
[10]白刚,黄敦胜.闭合撬拨手法复位外固定治疗跟骨骨折的临床研究[J].黑龙江医药, 2015,28(1):167-169.
[2]魏世隽,蔡贤华,黄继锋,等.双侧小切口微型接骨板组合内固定治疗SandersⅢ型跟骨关节内骨折[J].中华创伤骨科杂志,2016,18(9):753-759.
[3]徐浩,张晓剑,黄晟,等.经跗骨窦小切口空心钉内固定治疗跟骨骨折疗效分析[J].中国矫形外科杂志, 2017,25(12):1139-1142.
[4]陈善豪.小切口微创解剖钢板联合加压螺栓与传统解剖钢板联合螺钉治疗跟骨关节内骨折的临床效果对比[J].临床合理用药杂志,2016,9(15):116-117.
[5]杨东生.小切口微型锁定钢板内固定术治疗跟骨关节内骨折的手术疗效及对踝关节功能的影响[J].临床医药文献电子杂志,2015,2(8):1429,1432.
[6]胡通洲,王徐灿.小切口微创解剖钢板和加压螺栓治疗跟骨关节内骨折的临床比较[J].浙江创伤外科,2015,20(5):871-873.
[7]卢志文,叶庆林,吴柏初,等.3D打印辅助跗骨窦小切口治疗跟骨骨折的效果观察[J].中国当代医药, 2018,15(7):103-105.
[8]白洪涛,王硕磊,谢昆,等.跗骨窦联合跟腱旁纵行切口与外侧L型切口行钢板内固定治疗跟骨骨折疗效比较[J].中国临床研究, 2018, 31(4):86-88.
[9]陈燕才.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[J].牡丹江医学院学报, 2017, 38(4):53-55.
[10]白刚,黄敦胜.闭合撬拨手法复位外固定治疗跟骨骨折的临床研究[J].黑龙江医药, 2015,28(1):167-169.