经跗骨窦切口微创钢板内固定治疗跟骨骨折疗效分析
|
摘要
目的探讨经跗骨窦切口微创钢板内固定治疗跟骨骨折的疗效和安全性。方法根据信封法将156例跟骨骨折患者分为研究组(n=78)和对照组(n=78)。研究组采用经跗骨窦切口微创钢板内固定治疗,对照组采用外侧扩大入路切开钢板内固定治疗。比较两组手术时间、术中出血量、术后出血量、骨折愈合时间及并发症发生率;采用Maryland足部功能评分评价两组术后6、12和24个月的足功能恢复情况。结果患者均获得随访,时间24～81个月。与对照组比较,研究组手术时间延长,术中出血量和术后出血量减少,骨折愈合时间缩短,术后6、12和24个月的Maryland足部功能评分优良率升高,各项指标差异均有统计学意义(P <0. 05)。两组术后感染、延迟愈合、皮瓣坏死、足外侧麻木、后足僵硬感等并发症发生率比较差异无统计学意义(P> 0. 05)。结论经跗骨窦切口微创钢板内固定治疗跟骨骨折的疗效和安全性良好。
Objective To investigate the curative effect and safety of tarsal sinus incision minimally invasive plate internal fixation for treating calcaneal fractures. Methods The 156 cases of patients with calcaneal fractures were divided into research group( n = 78) and control group( n = 78) according to the envelope method. The research group was treated with tarsal sinus incision minimally invasive plate fixation. The control group was treated with lateral expansion of the plate fixation. The operation time,intraoperative blood loss volume,postoperative blood loss volume,fracture healing time and complications incidence rate of the two groups were compared. At postoperative 6,12 and24 months,the Maryland foot function score was used to evaluate the recovery of foot function in the two groups. Results The patients were followed up for 24 ～ 81 months. Compared with the control group,the operation time of the research group was prolonged,the intraoperative blood loss volume and postoperative blood loss volume of the research group were reduced,the fracture healing time of the research group was shortened,and the postoperative 6,12 and 24 months excellent-good rate of Maryland foot function score of the research group were increased,and the differences in the indexes were statistically significant( P < 0. 05). The differences in the postoperative infection,delayed healing,flap necrosis,foot numbness,hindfoot stiffness and other complications incidence rate in the two groups were not statistically significant( P > 0. 05). Conclusions Tarsal sinus incision minimally invasive plate fixation treating calcaneal fractures can gain good curative effect and safety.
Objective To investigate the curative effect and safety of tarsal sinus incision minimally invasive plate internal fixation for treating calcaneal fractures. Methods The 156 cases of patients with calcaneal fractures were divided into research group( n = 78) and control group( n = 78) according to the envelope method. The research group was treated with tarsal sinus incision minimally invasive plate fixation. The control group was treated with lateral expansion of the plate fixation. The operation time,intraoperative blood loss volume,postoperative blood loss volume,fracture healing time and complications incidence rate of the two groups were compared. At postoperative 6,12 and24 months,the Maryland foot function score was used to evaluate the recovery of foot function in the two groups. Results The patients were followed up for 24 ～ 81 months. Compared with the control group,the operation time of the research group was prolonged,the intraoperative blood loss volume and postoperative blood loss volume of the research group were reduced,the fracture healing time of the research group was shortened,and the postoperative 6,12 and 24 months excellent-good rate of Maryland foot function score of the research group were increased,and the differences in the indexes were statistically significant( P < 0. 05). The differences in the postoperative infection,delayed healing,flap necrosis,foot numbness,hindfoot stiffness and other complications incidence rate in the two groups were not statistically significant( P > 0. 05). Conclusions Tarsal sinus incision minimally invasive plate fixation treating calcaneal fractures can gain good curative effect and safety.
引文
[1]陈志军,朱东波,王树金,等.跗骨窦切口钢板螺钉治疗SandersⅡ、Ⅲ型跟骨骨折[J].临床骨科杂志,2017,20(2):220.
[2]Sonmez M M,Armagan R,Ugurlar M,et al.Allografts versus equine xenografts in calcaneal fracture repair[J].J Foot Ankle Surg,2017,56(3):510-513.
[3]马骏,何斌,姜曙祥,等.“八”字微创入路内固定治疗跟骨骨折疗效观察[J].局解手术学杂志,2017,26(4):256-259.
[4]Silva L C,Heck J M,Guerra M T.Surgical treatment of intraarticular fractures of the calcaneus:comparison between flat plate and calcaneal plate[J].Rev Bras Ortop,2016,52(1):29-34.
[5]孙昌俊,李力更,毕若杰,等.“L”入路与“八字”微创入路治疗跟骨骨折的比较[J].中国医学科学院学报,2015,37(6):733-736.
[6]刘承伟,邱冰,刘福尧,等.微创复位有限内固定结合外支架固定治疗36例跟骨骨折研究[J].重庆医学,2016,45(32):4577-4578,4592.
[7]Schepers T,Backes M,Dingemans S A,et al.Similar anatomical reduction and lower complication rates with the sinus tarsi approach compared with the extended lateral approach in displaced intra-articular calcaneal fractures[J].J Orthop Trauma,2017,31(6):293-298.
[8]Park J,Che J H.The sinus tarsi approach in displaced intra-articular calcaneal fractures[J].Arch Orthop Trauma Surg,2017,137(8):1055-1065.
[9]孔令超,宁仁德,谢武昆,等.微型钢板结合跗骨窦切口治疗SandersⅡ、Ⅲ型跟骨骨折的疗效[J].临床骨科杂志,2017,20(4):487-489.
[2]Sonmez M M,Armagan R,Ugurlar M,et al.Allografts versus equine xenografts in calcaneal fracture repair[J].J Foot Ankle Surg,2017,56(3):510-513.
[3]马骏,何斌,姜曙祥,等.“八”字微创入路内固定治疗跟骨骨折疗效观察[J].局解手术学杂志,2017,26(4):256-259.
[4]Silva L C,Heck J M,Guerra M T.Surgical treatment of intraarticular fractures of the calcaneus:comparison between flat plate and calcaneal plate[J].Rev Bras Ortop,2016,52(1):29-34.
[5]孙昌俊,李力更,毕若杰,等.“L”入路与“八字”微创入路治疗跟骨骨折的比较[J].中国医学科学院学报,2015,37(6):733-736.
[6]刘承伟,邱冰,刘福尧,等.微创复位有限内固定结合外支架固定治疗36例跟骨骨折研究[J].重庆医学,2016,45(32):4577-4578,4592.
[7]Schepers T,Backes M,Dingemans S A,et al.Similar anatomical reduction and lower complication rates with the sinus tarsi approach compared with the extended lateral approach in displaced intra-articular calcaneal fractures[J].J Orthop Trauma,2017,31(6):293-298.
[8]Park J,Che J H.The sinus tarsi approach in displaced intra-articular calcaneal fractures[J].Arch Orthop Trauma Surg,2017,137(8):1055-1065.
[9]孔令超,宁仁德,谢武昆,等.微型钢板结合跗骨窦切口治疗SandersⅡ、Ⅲ型跟骨骨折的疗效[J].临床骨科杂志,2017,20(4):487-489.