两种微创内固定手术治疗SandersⅡ型跟骨骨折的疗效比较

Comparison of two kinds of minimally invasive internal fixation for the treatment sanders Ⅱ calcaneal fracture

目的比较应用撬拨复位内固定以及跗骨窦切口切开复位钢板固定治疗SandersⅡ型跟骨骨折患者的临床效果。方法 68例SandersⅡ型跟骨骨折患者,按照自愿、随机原则分为观察组和对照组,每组34例。对照组采用跗骨窦切口行切开复位内固定治疗;观察组采用撬拨复位内固定治疗。对两组患者的术中出血量,手术时间,住院时间,住院费用,围手术期并发症,术后B?hler角,Gissane角的恢复情况以及两组患者术后12个月的的临床治疗效果(采用Maryland足部评分系统)进行评价。结果观察组手术时间、术中出血量、住院时间,围手术期并发症,住院平均费用均明显少于对照组,差异均有统计学意义(P<0.05)。两组患者术后B?hler角,Gissane角的恢复情况以及术后12个月Maryland足部评分系统评分,差异无统计学意义(P>0.05)。结论撬拨复位内固定治疗SandersⅡ型跟骨骨折效果与跗骨窦切口切开复位内固定相仿,具有住院费用低,并发症少,术后恢复快,创伤小等优势,值得在临床中推广应用。

Objective To compare the clinical effect of Sanders Ⅱ calcaneal fracture with closed percutaneous reduction by leverage internal fixation and open reduction internal fixation with tarsal sinus incision. Methods 68 cases of Sanders Ⅱ calcaneal fractures,in accordance with the principle of voluntary,randomly divided into observation group and control group,34 patients in each group. Open reduction internal fixation with tarsal sinus incision was adopted in control group,closed percutaneous reduction by leverage internal fixation was used in observation group. Intraoperative blood loss,operation time,postoperative Bohler angle,Gissane angle,hospital stays,perioperative complications,and clinical outcomes at 12 months postoperatively in both groups（using Maryland Foot Rating system）were evaluated. Results The operation time,intraoperative blood loss,hospital stay,perioperative complications and the average cost of hospitalization of observation group were significantly less than that of the control group（P〈0.05）. Postoperative B？hler angle,Gissane angle recovery,and Maryland foot scoring system scores in the two groups were not significantly different（P〉0.05）. Conclusion The clinical effects of closed percutaneous reduction by leveraged internal fixation for Sanders Ⅱ calcaneal fractures are similar to the tarsal sinus incision open reduction internal fixation,but the former method has low hospitalization costs,fewer complications,quick recovery,less trauma and so on,it is worth to promote in clinical.