“L”型与“八”型切口入路手术治疗跟骨关节内骨折效果比较

The treatment effect between type “L” and “splay” applied on intra-articular calcaneal fracture of calcaneus

(1)目的比较"L"型切口和"八"型切口入路手术治疗跟骨关节内骨折的临床疗效。(2)方法回顾性分析2012年5月~2015年5月分别使用"L"型切口和"八"型切口入路手术治疗并获得随访的212例(241足)跟骨关节内骨折的患者临床资料。按手术切口入路将患者分成两组:"L"型切口入路组112例(131足),男99例,女13例;Sanders分型:Ⅱ型35足,Ⅲ型74足,Ⅳ型22足。"八"型切口入路组100例(110足),男93例,女7例;Sanders分型:Ⅱ型29足,Ⅲ型64足,Ⅳ型17足。两组患者在年龄、性别、Sanders分型等方面差异无统计学意义。比较两组患者术前时间、手术时间、术中出血量、术后出血量、切口愈合时间及相关并发症的差异。(3)结果两组随访时间分别20.2个月和20.7个月,"L"型切口入路组平均术前时间、手术时间、术中出血量、术后出血量、切口愈合时间和相关并发症分别为(8.08±2.43)天、(72.15±3.34)分钟、(68.57±8.13)mL、(259.91±78.92)mL、(18.21±5.09)天和33.59%;"八"型切口入路组分别为(3.80±1.62)天、(52.22±10.38)分钟、(45.88±11.63)mL、(196.84±45.29)mL、(12.00±2.13)天和3.64%,两组比较差异均有统计学意义(P=0.000)。(4)结论 "八"型切口术前时间明显缩短,手术时间更短,术中、术后出血量及并发症更少,是治疗跟骨关节内骨折的良好选择。

Objective To compare the clinical effect between type ＂L＂ and ＂splay＂ applied on intra-articular calcaneal fracture. Method A total of 212 patients were treated by type ＂L＂ and ＂splay＂, they were selected from May 2012 to May 2015 with 241 feet.The data of the patients with intra-articular calcaneal fracture was collected and analyzed retrospectively.112 cases were in group A were applied type ＂L＂ incision,totally 131 feet including Sanders Ⅱ to Ⅳ 35,74 and 22 respectively.100 cases were in group B were applied type ＂splay＂ incision,totally 110 feet including Sanders Ⅱ to Ⅳ 29,64 and 17 respectively.h had no statistical difference between age, gender, Sanders type and so on. Operation time,preoperative time, blood loss and healing time were determined and compared between two groups. Results The average time of follow-up was 20 month.The preoperative time,operation time, intraoperatve blood soss,postoperative blood loss and healing time of group A was （8.08±2.43） days, （72.15±3.34）min, （68.57±8.13）mL, （259.91±78.92）mL and （18.21±5.09） days,all the indexes were higher than that of group B was （3.80±1.62） days, （52.22±10.38）min,（45.88±11.36）mL, （196.84±45.29）mL and （12.00±2.13） days respectively.It had statistically significance. Conclusion Treament of type ＂splay＂ apply on intra-articular calcaneal fracture can shorten operation time, decrease blood loss and complications.h is a good choice in treating intra-articular calcaneal fracture.