三联微创切口与传统“L”外侧切口治疗跟骨骨折疗效对比

Comparison with triple minimally incision and traditional “L” incision for calcaneal fracture

目的:通过回顾性分析,对两种切口在治疗跟骨骨折中多个指标进行对比,为临床治疗提供新思路。方法:选择跟骨骨折患足48例,SandersⅠ型9例,SandersⅡ型15例,SandersⅢ型18例;SandersⅣ型6例,随机分为微创组和传统组进行治疗,并随访12个月。对比平均术前等待时间、平均手术时间、术后功能恢复情况及并发症发生率。结果:两组患者平均术前等待时间有显著统计学差异(P<0.001),微创组等待时间(133±66)h,较传统组(247±52)h短。两组患者术后B9lher角和Gissane角的恢复无显著差异。虽然两组患者在皮瓣坏死率(微创组0%,传统组17.65%)和感染率(微创组0%,传统组5.88%)无统计学差异,但微创组较传统组发生率低。两组患者术后功能恢复情况无显著性差异(P=0.986),但传统组有1例患者因皮瓣坏死后进行皮瓣修复而抱怨美观受到影响。结论:三联微创切口在治疗跟骨骨折上总体优于传统"L"型外侧切口,是一种可以推广的新入路。

Objective:To provide a new method for calcaneal fractures by comparing the different kinds of incision.Methods:48cases of calcaneal fracture,9cases of sanders I,15cases of sanders11,18cases of sanders III,6cases of sanders IV,and randomly divided into minimally group and traditional group were treated and followed up in12months.The average waiting time,average opera-tion time,postoperative functional recovery and complications were compared.Results:There was a significant difference between two groups in average preoperative waiting time(P<0.001)and the waiting time of the minimally group was(133±66)h,which was shor-ter than(247±52)h of the traditional group.The recovery of2groups of patients,Bolher angle and Gissane angle had no significant difference.Although there was no significant difference between the two groups in the rate of skin flap necrosis(minimally group was0%,traditional group17.65%)and infection rate(minimally group was0%,traditional group5.88%),but the incidence rate of min-imally group was lower than that of the traditional group.There was no significant difference in postoperative functional recovery between the two groups(P=0.986),but in the traditional group,there were1patient who complained about the appearance of the flap after the flap operation.Conclusion:The minimally incision for calcaneal fractures is superior to the traditional type lateral incision.It is a new way to be popularized.