【摘要】 目的比较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临床疗效。方法选取2013年1月至2015年6月在广东佛山三水区人民医院行跟骨骨折治疗的116例患者,按照数字表法随机分成观察组和对照组,对照组患者采用传统外侧L型切口钢板内固定,观察组采用跗骨窦小切口钢板内固定。记录两组切口长度、手术时间、术中出血量和骨折愈合时间,比较两组患者手术前后美国足踝外科学会(AOFAS)评分、Kofoed评分、Maryland评分、影像学Gissane角和Bohler角以及术后并发症发生情况。结果观察组切口长度、手术时间、术中出血量、骨折愈合时间、术后并发症发生率均优于对照组(P<0.05)。术后1年两组各关节功能评分和影像学参数均明显优于术前(P<0.05),但两组比较,差异无统计学意义(P>0.05);观察组术后AOFAS评分优良率明显高于对照组(P<0.05)。结论跗骨窦小切口和传统外侧L型切口钢板内固定治疗跟骨骨折均能获得满意的临床效果,前者在减轻手术创伤、缩短骨折愈合时间、降低术后并发症发生率、促进早期功能锻炼等方面具有一定优势。更多还原

【Abstract】 Objective To compare the difference of clinical effects of internal fixation via sinus tarsi approach versus traditional lateral L-type approach for treatment of calcaneal fractures. Methods A total of 116 patients with calcaneal fractures treated in People’s Hospital of Sanshui District from January 2013 to June 2015,were randomly divided into observation and control groups using a random numerical table. Patients in control group underwent plate internal fixation through traditional lateral L-type approach, while patients in observation group were treated by plate internal fixation through sinus tarsi approach. Incision length, operation time,intraoperative estimate blood loss and fracture healing time were recorded in two groups, American Orthopaedic Foot and Ankle Society(AOFAS) score, Kofoed score, Maryland score, radiographic Gissane angle and Bohler angle at preoperation and postoperation, as well as postoperative complications were compared between two groups. Results Incision length, operation time, intraoperative estimate blood loss, fracture healing time and incidence of postoperative complications in observation group were better than those in control group, there were statistical differences between two groups(P <0.05). The above joint function scores and radiological parameters at 1 year after operation were all improved compared with preoperative ones(P <0.05), while there were no statistical differences between two groups at postoperation(P >0.05); But postoperative excellent and good rate of AOFAS score in observation group was higher than that in control group(P <0.05). Conclusions Clinical effect of either sinus tarsi approach or traditional lateral L-type approach is satisfactory; Plate internal fixation through sinus tarsi approach has the advantages of alleviating surgical injury, shortening fracture healing time,reducing postoperative complications and promoting early function rehabilitation.更多还原