跗骨窦切口微创治疗SandersⅢ型跟骨骨折的临床观察

目的观察跗骨窦切口微创内固定术治疗SandersⅢ型跟骨骨折的疗效。方法2013年12月至2016年10月SandersⅢ型跟骨骨折患者52例（52足）．随机分成2组。观察组（26例，26足）采用跗骨窦切口皮螺钉内固定治疗，对照组（26例，26足）采用常规外侧“L”切口钢板内固定治疗。观察两组患者手术前后跟骨宽度、跟骨长度、Bohler角7ZGissane角，比较两组患者的临床效果。结果观察组患者跟骨宽度、跟骨长度、Bohler角及Gissane角的恢复情况明显优于对照组，差异有统计学意义（P〈0．05），观察组术后无并发症发生，对照组有5例切口并发症发生。观察组患者治疗后优良人数明显多于对照组患者，差异有统计学意义（x^2=5．5319，P=-0．0187）。结论跗骨窦切口微创术具有切口并发症少，固定牢固，对复位骨折治疗安全有效，是临床治疗SandersⅢ型跟骨骨折效果良好的一种技术，值得推广。

Objective To observe the clinical effect of tarsal sinus incision minimally invasive surgery for the treatment of Sanders type Ⅲ calcaneal fracture. Methods 52 cases （ 52 feet ） of Sanders type Ⅲ calcaneal fractures treated in our hospital from October 2016 to December 2013 were randomly divided into two groups. A group of study group （ 26 cases, 26 feet ） and a group of control group （ 26 cases, 26 feet ） . The study group （ 26 cases, 26 feet ） with tarsal sinus incision screw fixation treatment while the control group （ 26 cases, 26 feet ） were treated with conventional lateral ＂L＂ incision plate fixation. The calcaneal width, calcaneal length, Bohler angle Gissane angle observation and the clinical effect comparison in the two groups before and after the operation were discussed and analyzed. Results The study group after surgery with minimally invasive treatment of tarsal sinus incision in patients with calcaneal calcaneal width, length, Bohler angle and Gissane angle of recovery were significantly better than the control group patients who underwenttake regular ＂L＂ incision reduction plate, the difference was statistically significant （P〈0.05） , and none of the patients after surgery, research the postoperative complications in the group, the control group had 5 cases of postoperative incision complications are not ideal, better than the control group, the overall recovery of study group patients. Patients in the study group after treatment was significantly less than the number of excellent patients in the control group, the difference was statistically significant （ x^2=5.5319, P=0.0187 ） . Conclusion Tarsal sinus incision minimally invasive surgery with incision complications, firm fixation of fractures is a safe and effective treatment, good technical effect on clinical treatment of Sanders type RI calcaneal fractures, worthy of promotion.