【摘要】 目的探讨跗骨窦切口钢板内固定联合经皮置钉技术微创治疗Sanders II、Ⅲ型跟骨骨折的临床疗效。方法回顾性分析2016年5月至2017年12月采用跗骨窦切口钢板内固定联合经皮置钉技术微创治疗并获得随访的23例病例资料。其中,Sanders II型15例,SandersⅢ型8例;男15例,女8例;年龄22～61岁,平均年龄44.2岁。记录术后软组织情况,测量跟骨术前、术后及随访X线片的B?hler角、Gissane角、骨折复位情况及骨折愈合时间,对测量数据采用SPSS 20.0软件进行统计学分析,并于末次随访时按照Maryland足部评分系统进行评分。结果经过10～13个月(平均11.8个月)随访。术后所有跟骨均达到解剖复位或近乎解剖复位,且均无切口边缘皮肤坏死、血肿形成。骨折全部愈合,愈合时间3～6个月,平均4.4个月。术后B?hler、Gissane角与术前比较差异有统计学意义(<0.01)。根据Maryland评分,优13例,良8例,可2例,优良率为91.3%。2例有腓肠神经损伤表现。结论跗骨窦切口钢板内固定联合经皮置钉术具有创伤小、切口并发症少、复位固定可靠的优点,可用于治疗Sanders II、Ⅲ型跟骨骨折,临床疗效满意。更多还原

【Abstract】 Objective To investigate the clinical effects of the sinus tarsi approach and plate fixation with minimal-invasive percutaneous pedicle screw technology in treating calcaneal fractures of Sanders type II&III. Methods From May 2016 to December 2017, 23 patients with calcaneal fractures(Sanders type II&III) were treated with minimal-invasive percutaneous pedicle screw using the sinus tarsi approach and plate fixation. There were 15 males and 8 females with age ranging from 22 to 61 years(mean, 44.2 years). According to the classification of Sanders, 15 case were classified as type II, and eight as type III.The soft tissue condition after operation was recorded. Fracture reduction and healing time were measured. Record and compare the B?hler angle and Gissane angle before and after operation. Maryland foot score system was used to evaluate the clinical results. All data were statistically analyzed with SPSS 20.0 software.Results All the patients were followed up for 10 to 13 months( mean, 11.8 months). All of the calcaneus achieved anatomic reduction or nearly anatomic reduction. There were no incision infection, necrosis or hematoma. All fractures healed and fracture healing time ranged from 3 to 6 months( mean, 4.4 months). B?hler angle and Gissane angle were significantly improved in all patients( <0.01). According to Maryland foot score system, 13 cases were defined as excellent, 10 cases as good, and 2 cases as poor. The excellent and good rate was 91.3%.Two cases suffered from sural nerve injury. Conclusion Sinus tarsi approach and plate fixation with minimal-invasive percutaneous pedicle screw technology is an effective method for the treatment of calcaneal fractures of Sanders type II&III. It has the advantages of small trauma, safe operation, limited complicatio, table fixation.更多还原