闭合跟骨骨折的手术治疗

Surgical treatment of closed fractures of the calcaneus

目的探讨跟骨骨折内固定手术中微创操作技术的应用方法及效果。方法手术治疗194例急性闭合跟骨骨折患者(214足),采用跟骨外侧改良L形切口、微创操作暴露、跟骨钢板固定。术前、术后进行影像学评估。结果 194例均获得随,时间12～30(14.8±4.8)个月。切口坏死感染率为7.01%。切口并发症发生率为9.35%。Bhler角术前为5.6°±9.7°,术后矫正为30.1°±5.1°;Gissane角术前为90.5°±11.2°,术后矫正为120.3°±6.4°。术后1年按Maryland Foot Score系统评价疗效:优90足,良103足,可18足,差3足,优良率为90.19%。结论跟骨骨折内固定手术中应用外科微创操作技术,可以减少切口并发症,效果满意。

Objective To explore the minimally invasive technique application method and effect of internal fixation of calcaneal fractures. Methods 194 cases of acute closed fracture of calcaneus （214 feet） were treated with internal fixation using lateral modified L shaped incision and minimally invasive operation exposure. Preoperative and postoperative radiologic evaluation was performed. Results 194 patients were followed up for 12 -30 （14. 8 ± 4.8 ） months. Among them, necrotic wound infection rate was 7.01%. Incision complication rate was 9. 35%. Bohler angle was corrected from 5.6° ±9. 7° preoperatively to 30. 1° ± 5.1° postoperatively. Gissane angle was corrected from 90. 5° ± 11.2°preoperatively to 120. 3°±6.4°postoperatively. 1 year later, the therapeutic effects was evaluated with Maryland Foot Score system, the results was excellent in 90 feet, good in 103 feet, fair in 18 and poor in 3,the excellent and good rate was 90. 19%. Conclusions Minimally invasive surgical techniques means less wound complication rate and more satisfactory surgical outcome in the operation of internal fixation of calcaneal fracture.