摘要
[目的]比较两种不同方法治疗SandersⅡ、Ⅲ型跟骨关节内骨折的疗效。[方法]对跟骨关节内骨折分别进行经跗骨窦微创小切口切开锁定钢板外固定（18例20足）和外侧＂L＂形切口切开复位钢板内固定（20例21足）治疗,比较两组病例一般资料、围手术期指标和影像学指标,按照Maryland足功能评分系统对疗效进行比较。[结果]随访6~30个月,平均15.6个月。两组的一般资料、骨折愈合时间、术后Maryland评分及优良率比较无差别（P〉0.05）,经跗骨窦微创小切口组的受伤至手术时间、术中失血量、切口长度、手术时间、住院时间及术后并发症优于外侧＂L＂形切口组（P〈0.05）。两组术后放射学指标均优于术前（P〈0.05）,组间比较无差别（P〉0.05）。[结论]两种方法治疗SandersⅡ、Ⅲ型跟骨关节内骨折的临床疗效较好且疗效相仿,但经跗骨窦微创小切口治疗具有较大的手术操作简单、创伤小、并发症少等微创手术优势。
[Objective]To compare the curative effects of two different methods in treatment of SandersⅡ or Ⅲ stages intra- articular calcaneal fractures. [Method]Eighteen cases（ 20 feet） were treated with minimally invasive sinus tarsi approach and external fixation with calcaneal locking plates. Twenty cases（ 21 feet） were treated with lateral intensive L- shaped incision for open reduction and internal fixation. The perioperative indices were statistically ananlyzed,such as general information,perioperative indicators and imaging indicators. The curative effect was assessed clinically according to the Maryland foot function scoring system. [Result]The 6- 30 months follow- up were taken in all the patients（ average 15. 6 months）. There were no significantly statistical differences in general information,time of fracture clinical healing,the Maryland score and good result rate（ P 0. 05）. There were significantly short time interval from injury and less blood loss and short length of incision and short operation time and short time in hospital and fewer postoperative complications in the group of minimally invasive sinus tarsi approach and external fixation with calcaneal locking plates than that in the group of lateral intensive L- shaped incision for open reduction and internal fixation（ P 0. 05）. Two groups of postoperative radiological indicators were better than that of the preoperative（ P 0. 05）,but there were no significantly statistical differences between the two groups（ P 0. 05）. [Conclusion]There was good clinical curative effect and had the same clinical effect in the two groups treated by minimally invasive sinus tarsi approach and external fixation with calcaneal locking plates and lateral intensive L-shaped incision for open reduction and internal fixation,but the minimally invasive sinus tarsi approach and external fixation with calcaneal locking plates is simple with less trauma and less complications,is a minimally invasive surgery.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2015年第6期496-501,共6页
Orthopedic Journal of China
基金
广西卫生厅科技计划课题(编号:Z2012222)
关键词
跟骨
关节内骨折
骨折固定术
calcaneus
intra-articular fractures
fracture fixation
