改良微创小切口切开复位内固定治疗跟骨骨折的临床效果

Clinical effect of modified minimally invasive incision open reduction internal fixation in the treatment of calcaneal fractures

目的观察改良微创小切口切开复位内固定治疗跟骨骨折的临床效果。方法将120例跟骨骨折患者随机分为对照组与观察组,各60例,对照组采用切开复位内固定治疗,观察组采用改良微创小切口切开复位内固定治疗。比较两组治疗效果。结果观察组手术时间、术中出血量、骨折愈合时间均显著优于对照组(P<0.05);观察组的关节疼痛、日常活动评分及总分均显著高于对照组(P<0.05);治疗后,两组Bohler角、Gissane角均显著增大,且观察组均大于对照组(P<0.05);治疗后,两组切口明显肿胀、皮缘色暗、表皮水疱发生率均显著降低,且观察组治疗后的皮缘色暗发生率显著低于对照组(P<0.05);治疗后3个月,两组骨痂生长情况评分均显著增高,且观察组高于对照组(P<0.05)。结论采用改良微创小切口切开复位内固定治疗跟骨骨折,具有手术时间短,术中出血量少,骨折愈合快,术后踝关节功能、疼痛程度、Bohler角、Gissane角改善明显等优势,值得临床推广应用。

Objective To observe the clinical effect of modified minimally invasive incision incision open reduction internal fixation in the treatment of calcaneal fractures. Methods One hundred and twenty patients with calcaneal fractures were randomly divided into control group and observation group, with 60 cases in each group. The control group was treated with open reduction internal fixation. The observation group was treated with modified minimally invasive incision incision open reduction internal fixation. The treatment effects in the two groups were compared. Results The operation time, the amount of intraoperative blood loss and the time of fracture healing in the observation group were significantly better than those in the control group （P〈0.05）. The joint pain, daily activity score and total score of the observation group were significantly higher than those of the control group （P〈0.05）. After treatment, the Bohler＇s angle and Gissane＇s angle of the two groups increased significantly, and those in the observation group were bigger than the control group （P〈0.05）. After treatment, the incidences of significant swelling of the incision, dark skin edge and epidermal blister in the two groups significantly reduced, and the incidence of dark skin edge in the observation group was significantly lower than that in the control group （P〈0.05）. At three months after treatment, the scores of osteophyte growth in both groups significantly increased, and that in the observation group was higher than the control group （P〈 0.05）. Conclusion The modified minimally invasive incision open reduction internal fixation in the treatment of calcaneal fractures has the advantages of short operation time, less intraoperative blood loss, rapid fracture healing, significant improvement of postoperative ankle function, pain degree, Bohler＇s angle and Gissane＇s angle, which is worthy of clinical promotion and application.