关节镜下外侧有限切口空心螺钉治疗跟骨骨折

The treatment for calcaneal fractures under the arthroscope assisted by hollow bolt from limited lateral incision

目的探讨关节镜下跟骨骨折治疗的新方法和疗效。方法选择SandersⅡ～Ⅳ型跟骨骨折共28例,采用外侧经跗骨窦有限切口于关节镜辅助下应用空心螺钉内固定进行治疗,对手术前后关节解剖数值及AOFAS评分进行比较统计。结果与术前相比,SandersⅡ型组跟骨高度前后的数值并无统计学差异(P>0.05),其余数据统计分析表明,术前术后患者的Bohler角、Gissane角和跟骨的长、宽、高度方面,均有显著差异(P≤0.05)。术后关节功能据AOFAS评分,优21例、良4例、可3例,关节功能优良率达89.3%。结论关节镜下外侧有限切口空心螺钉治疗跟骨骨折可缩短术前住院时间,减少术中跟骨血供的破坏,可达良好解剖复位内固定,减少术后软组织并发症及创伤性关节炎的发生,是一种较好的治疗方法。

Objective To expoler the new method and clinical efficacy of arthroscope in the treatment of calcaneal fractures.Methods 28 cases of calcaneal fracture classed with Sanders Ⅱ-Ⅳ,treated by using the lateral beside tarsus sinus limited incision under the arthroscope assisted by fixed hollow screw,data of the anatomy functional of joints and the AOFAS numerical scores were analyzed.Results The calcaneal height values after operation in SandersII based group were not statistically different compared with those of the preoperative（P0.05）,but there were significant differences in Bohler angle,Gissane angle,calcaneal length,width,height,（P≤0.05）.According to AOFAS score criterion,21 cases were excellent,4 cases good,3 cases fair,the excellent and good rate of joint function was 89.3%.Conclusion The arthroscope assisted by hollow bolt from limited lateral incision for calcaneal fractures treatment can shorten hospital stay before surgery,reduce the damage of the blood supply,achieve a good anatomic reduction and internal fixation,reduce postoperative complications of soft tissue and the incidence of traumatic arthritis.