【摘要】 目的 比较跗骨窦入路与外侧L形入路钢板内固定治疗Sanders Ⅱ、Ⅲ型跟骨骨折的临床疗效。方法 回顾性分析自2017-01—2019-01采用跗骨窦入路与外侧L形入路钢板内固定治疗的86例（92足）SandersⅡ、Ⅲ型跟骨骨折，45例（47足）采用跗骨窦入路（观察组），41例（45足）采用外侧L形入路（对照组）。采用AOFAS踝-后足评分评价功能恢复情况，比较两组手术时间、术中失血量、切口长度、切口及骨折愈合时间、骨折至手术时间，以及术后6个月跟骨的长度、宽度、高度、B?hler角及Gissane角。结果 观察组在骨折至手术时间、术中失血量、切口长度、切口愈合时间方面均优于对照组，差异有统计学意义（P<0.05），两组手术时间、骨折愈合时间比较差异无统计学意义（P>0.05）。术后6个月时两组跟骨的长度、宽度、高度、B?hler角及Gissane角比较差异无统计学意义（P>0.05）。术后6个月观察组的AOFAS评分为（88.3±6.9）分，优34足，良11足，可2足；对照组的AOFAS评分为（87.4±4.7）分，优29足，良10足，可2足。结论 跗骨窦入路钢板内固定治疗Sanders Ⅱ、Ⅲ型跟骨骨折更具有优势，其对软组织条件要求较低，明显缩短了术前等待时间，并且手术创伤小、术后恢复快。更多还原

【Abstract】 Objective To compare the clinical efficacy of the tarsal sinus approach with the lateral L-incision approach and plate internal fixation in the treatment of Sanders Ⅱ and Ⅲ calcaneal fractures.MethodsEighty-six cases(92 feet) of Sanders type II and III calcaneal fractures treated with tarsal sinus approach or lateral L-incision approach and plate internal fixation from January 2017 to January 2019 were retrospectively analyzed, 45 cases(47 feet) with tarsal sinus approach(test group)and 41 cases(45 feet) with lateral L-incision approach(control group). The American Orthopedic Foot and Ankle Society(AOFAS) ankle-hindfoot index score was used to evaluate functional recovery. Operative time, intraoperative blood loss, incision length, incision and fracture healing time, fracture to surgery time, and the length, width, height, B?hler angle and Gissane angle of the calcaneal bone were compared at 6 months after surgery between the two groups.ResultsThe fracture-to-operation time, intraoperative blood loss, incision length, and incision healing time were better in the test group than in the control group,with statistically significant differences(P<0.05), while the differences in operation time and fracture healing time between the two groups were not statistically significant(P>0.05). There was no statistically significant difference in the length, width,height, B?hler angle, and Gissane angle between the two groups at 6 months postoperatively(P>0.05). The AOFAS score of the test group at 6 months postoperatively was(88.3±6.9), excellent in 34 feet, good 11 feet, and 2 feet; the AOFAS score of the control group was(87.4±4.7), excellent 29 feet, good 10 feet, and fair 2 feet.ConclusionThrough tarsal sinus approach and plate internal fixation is more advantageous in the treatment of Sanders Ⅱ and Ⅲ heel fractures, which requires less soft tissue conditions, significantly shortens the preoperative waiting time and provides less surgical trauma and faster postoperative recovery.更多还原