摘要
目的探讨跗骨窦延长切口与L形切口治疗SandersⅡ型跟骨骨折的临床疗效。方法对41例SandersⅡ型跟骨骨折患者进行切开复位解剖钢板内固定治疗,根据治疗方法分为观察组(采用跗骨窦延长切口,21例)和常规组(采用L形切口,20例)。比较两组手术时间、术中出血量、切口长度、B9hler角、术后皮肤坏死发生率。采用AOFAS踝-后足评分标准评价临床疗效。结果 41例患者均随访12个月。与常规组比较,观察组手术时间短、术中出血量少、手术切口小、术后皮肤坏死发生率低(P <0. 05)。末次随访时,两组B9hler角均较术前明显改善(P <0. 001),两组间比较差异无统计学意义(P> 0. 05)。术后3、6、12个月,两组AOFAS踝-后足评分均随时间延长不断提高,各时间段比较差异均有统计学意义(P <0. 05),两组间各时间段比较差异无统计学意义(P> 0. 05)。结论跗骨窦延长切口切开复位解剖钢板内固定治疗SandersⅡ型跟骨骨折创伤小,手术时间短,固定确切,疗效好。
Objective To investigate the clinical outcomes of extended sinus tarsal incision and conventional L-shaped incision for the surgery of Sanders type Ⅱcalcaneal fractures. Methods The 41 patients with Sanders typeⅡ calcaneal fractures were divided into the observation group（extended sinus tarsi incision,21 cases） and the convention group（conventional L-shaped incision,20 cases）. They were treated with open reduction and internal fixation（ORIF） by anatomical plate. Operative time, intraoperative blood loss, incision length, B hler angle and the incidence rate of skin necrosis were compared. Clinical efficacy was evaluated by AOFAS ankle-hind foot score. Results The 41 cases were successfully followed up for 12 months. Compared with the convention group, the observation group had advantages with shorter operative time, less intraoperative blood loss, smaller incision site and lower incidence rate of skin necrosis （ P〈 0.05）. The B hler angles of the two groups were both significantly improved at the last follow-up（ P〈 0.001）. But the differences between the two groups had no statistical significance （ P〉 0.05）. During the follow-up period of 3, 6 and 12 months after surgery, the AOFAS ankle-hind foot scores of both two groups had been improved significantly in proportion to duration of time （ P〈 0.05）.But the differences between two groups at different stages were not statistically significant （ P〉 0.05）. Conclusions ORIF by anatomical plate in the treatment of Sanders type Ⅱ calcaneal fractures through an extended sinus tarsi incision has advantages with shorter operative time,less complication and better efficacy.
作者
樊宗庆
聂宇
符东林
李立
李一凡
张峰
FAN Zong-qing;NIE Yu;FU Dong-lin;LI Li;LI Yi-fan;ZHANG Feng(Dept of Orthopaedics,the People′s Hospital of Fuyang,Fuyang,Anhui 236000,China)
出处
《临床骨科杂志》
2018年第5期627-630,共4页
Journal of Clinical Orthopaedics
关键词
跟骨骨折
跗骨窦切口
切开复位内固定
calcaneal fractures
sinus tarsi approach
open reduction and internal fixation
