辅助内侧小切口在纠正跟骨内翻畸形治疗中的应用体会

Application experience of auxiliary medial small incision in the treatment of calcaneus varus deformity

目的探讨辅助内侧小切口纠正严重跟骨骨折内翻畸形的临床疗效。方法选取2016年1月至2018年2月在本院治疗的20例跟骨骨折、骨折轴位内翻畸形严重病例,根据骨折粉碎程度采用跗骨窦切口或外侧L型切口恢复跟骨高度及关节面,并用内侧小切口辅助纠正跟骨内翻,骨折固定。采用美国足踝外科协会(AOFAS)评分标准进行评估。结果20例患者均进行了随访,所有患者跟骨内翻畸形均得到良好纠正,未出现伤口感染。术后AOFAS评分优有10例。术前后内翻角度比较,差异有统计学意义(P<0.05)。讨论跟骨骨折伴有严重跟骨内翻畸形采用内侧辅助小切口能很好地纠正跟骨内翻畸形,畸形纠正效果满意,且没有对跟骨其他因素的改善造成不利影响。

Objective To explore the clinical effect of auxiliary medial small incision in correcting the varus deformity of severe calcaneal fracture.Methods A total of 20 cases of severe calcaneal fractures and axial varus deformities in our hospital from January 2016 to February 2018 were selected.According to the degree of fracture comminuted,the tarsal sinus incision or lateral L-shaped incision was used to restore the calcaneus height and articular surface.A small medial incision was used to help correct calcaneus varus and fixation of the fracture.The American foot and ankle surgery association(AOFAS)scoring standard was used for evaluation.Results All 20 patients were followed up.All patients had a good correction of calcaneal varus deformity,and no wound infection occurred.There were 10 cases with excellent AOFAS score after operation.There was a statistically significant difference in varus angle before and after operation(P<0.05).Conclusion Using the medial auxiliary small incision in the calcaneal fracture with severe calcaneal varus deformity can correct the calcaneus varus deformity well,with satisfactory deformity correction effect,and without adverse effect on the improvement of other factors of the calcaneus.