【摘要】 目的 比较改良弧形切口和改良外侧L形切口内固定治疗跟骨骨折的疗效。方法 使用随机数生成器将118例SandersⅢ型跟骨骨折患者分为弧形组(采用改良弧形切口内固定治疗，59例)和L形组(采用改良外侧L形切口内固定治疗，59例)。比较两组围手术期指标及术后恢复情况、影像学指标、并发症发生情况。采用Maryland足功能评分评价疗效。结果 两组各4例失访或退出治疗，110例患者获得随访，时间6～8个月。术中出血量、手术时间弧形组多(长)于L形组(P<0.01)。住院时间、切口愈合时间、切口愈合不良率、切口感染率弧形组均短(低)于L形组(P<0.05)。术中透视次数、术后引流量、开始负重行走时间、骨折愈合时间两组比较差异均无统计学意义(P>0.05)。术后即刻及术后6个月Gissane角、B9hler角及跟骨宽度、长度、高度两组比较差异均无统计学意义(P>0.05)。术后6个月采用Maryland足功能评分评价的疗效优良率两组比较差异无统计学意义(P>0.05)。结论 改良弧形切口与改良外侧L形切口内固定治疗SandersⅢ型跟骨骨折，足部功能恢复效果相当。与改良外侧L形切口相比，改良弧形切口具有切口愈合时间短、患者恢复快、术后并发症发生率低的优势，但有术中出血量较多、手术时间较长的缺点。更多还原

【Abstract】 Objective To compare the efficacy of modified curved incision and modified lateral L-shaped incision internal fixation in the treatment of calcaneal fractures.Methods The 118 patients with Sanders type Ⅲ calcaneal fractures were randomly divided into curved group(treated with modified curved incision internal fixation, 59 cases) and an L-shaped group(treated with modified lateral L-shaped incision internal fixation, 59 cases) using a random number generator.Perioperative indexes, postoperative recovery status, imaging indexes, and incidence of complications were compared between the two groups.Maryland foot function score was used to evaluate the efficacy.Results Four cases were lost to follow-up or withdrew from treatment in each group, and 110 cases were followed up for 6～8 months.The intraoperative blood loss and operation time were higher(longer) in the curved group than those in the L-shaped group(P<0.01).The hospitalization time, incision healing time, poor incision healing rate, and incision infection rate were all shorter(lower) in the curved group than those in the L-shaped group(P<0.05).There were no statistical differences in intraoperative fluoroscopy frequency, postoperative drainage volume, starting weight-bearing walking time, and fracture healing time between the two groups(P>0.05).There were no statistical differences in Gissane angle, B9hler angle, and the width, length, height of the calcaneus between the two groups immediately after surgery and 6 months after surgery(P>0.05).At 6 months after surgery, the excellent-good rate of the Maryland foot function score had no difference between the two groups(P>0.05).Conclusions In the treatment of Sanders type Ⅲ calcaneal fracture, the modified curved incision and the modified lateral L-shaped incision internal fixation have the same effect on foot function recovery.Compared with the modified lateral L-shaped incision, the modified curved incision has the advantages of shorter wound healing time, faster patient recovery and lower postoperative complication incidence, but which has more disadvantages of intraoperative blood loss and longer operative time.更多还原