八字微创切口结合改良Donati-Allgower缝合法治疗糖尿病患者跟骨骨折的疗效分析

CLINICAL EFFECTS OF MODIFIED MINIMALLY INVASIVE INCISION COMBINED WITH MODIFIED DONATI-ALLGOWER SUTURE IN THE TREATMENT OF CALCANEAL FRACTURES IN DIABETIC PATIENTS

目的探讨应用八字微创切口结合改良Donati-Allgower缝合法治疗糖尿病患者跟骨骨折的疗效分析。方法以该院2010年2月-2012年5月,71例患糖尿病跟骨骨折患者(85足),其中34例患者(42足)采用跟骨外侧八字微创切口解剖跟骨板内固定,结合改良Donati-Allgower缝合法治疗,为观察组;37例患者(43足)采用传统跟骨外侧L形入路切口内固定结合普通间断缝合法治疗,为对照组。研究内容包括跟骨骨折的损伤程度(分型)、软组织并发症,术前及术后跟骨的跟骨结节关节角、跟骨交叉角,术后AOFAS评分,所得数据使用SPSS19.0统计软件进行分析。结果二组在性别、年龄、手术时机选择、术前损伤程度(骨折分型)、术前及术后跟骨的跟骨结节关节角、跟骨交叉角数值、术后AOFAS评分情况比较差异无统计学意义(P>0.05)。结论八字微创切口结合改良Donati-Allgower缝合法治疗糖尿病患者跟骨骨折可减少对术区软组织的破坏,保护切口皮缘血运,降低糖尿病患者跟骨骨折术后软组织并发症的发生率。

Objective To evaluate the efficacy of modified minimally invasive incision combined with modified Donati- Allgower suture in the treatment of calcaneal fractures in diabetic patients.Methods From February 2010 to May 2012,71 patients with diabetic calcaneal fractures （.85 feet）,34 patients （42 feet） were treated with calcaneal lateral trabecular incision anatomical calcaneal plate fixation,Combined with modified Donati- Allgower suture treatment for the observation group; 37 patients （43 feet） using the traditional calcaneal lat- eral L- shaped incision combined with conventional interrupted suture treatment,as the control group. The study included the degree of injury { classification） of the calcaneal fractures, the soft tissue complication, the calcaneal angle of the calcaneal tubercle, the calcaneal cross angle, the postoperative AOFAS score, and the da- ta obtained using SPSS17.0 Software for analysis. Results There were no significant differences in the AO- FAS score between the two groups at the sex, age, timing of operation, preoperative injury （fracture type）, calcaneal angle of ealcaneal tuberosity and calcaneus （P〉0.05）.Conclusion The improvement of Donati- Allgower suture in the treatment of caleaneal fractures in diabetic patients can reduce the destruction of soft tissue in the operation area,protect the incisional blood supply and reduce the incidence of soft tissue compli- cations after calcaneal fractures in diabetic patients.