微创小切口切开复位钢板内固定术治疗跟骨骨折37例

Minimally Invasive Incision of Open Reduction and Internal Fixation with Steel Plate for 37 Cases of Calcaneal Fractures

目的探讨微创小切口切开复位钢板内固定术治疗37例跟骨骨折的疗效及安全性。方法选取2015年2月-2016年10月我院收治的74例跟骨骨折患者按照随机数字表法分为2组,对照组37例行传统切开复位内固定术治疗,观察组37例行微创小切口切开复位钢板内固定术治疗。统计两组围术期指标、影像学检查结果、踝关节恢复情况,并记录并发症发生情况。结果观察组手术时长、骨折愈合时间明显短于对照组(P<0.01),术中出血量明显低于对照组(P<0.01);术后观察组踝-后足评分系统(AOFAS)评分明显高于对照组(P<0.05);观察组并发症发生率5.41%(2/37)明显低于对照组21.62%(8/37)(χ~2=4.163,P=0.041)。结论微创小切口切开复位钢板内固定术应用于跟骨骨折患者,术中出血少,可加快骨折愈合,明显改善踝关节功能,降低并发症发生率,值得广泛推广。

Objective To investigate the efficacy and safety of minimally invasive incision of open reduction and internal fixation with steel plate for 37 cases of calcaneal fractures.Methods 74 cases of calcaneal fractures treated in our hospital from February 2015 to October 2017 were randomly divided into two groups.The Control Group（ n = 37） were treated with traditional open reduction and internal fixation,and the Observation Group（ n = 37） were treated with minimally invasive incision of open reduction and internal fixation with steel plate. The perioperative indicators,imaging findings,ankle recovery,and incidence of complications in the two groups were statistically recorded. Results The operation duration,the amount of intraoperative bleeding and the healing time of fracture in the Observation Group were less than those in the Control Group（ P〈 0.01）.The score of ankle-posterior foot scoring system（ AOFAS） in the Observation Group was higher than that of the Control Group after the operation（ P〈 0.05）.The incidence of complications in the Observation Group（ 5. 41%,2/37） was lower than that in the Control Group（ 21. 62%,8/37）（ χ2= 4.163,P = 0. 041）.Conclusion The minimally invasive incision of open reduction and internal fixation with steel plate for calcaneal fractures has less intraoperative bleeding. It can accelerate fracture healing,improve ankle function,and reduce the incidence of complications. It is worth promoting widely.