跗骨窦小切口联合手法整复对跟骨骨折的疗效分析

Clinical Treatment Analysis on Effect of small Incision of Tarsal Sinus combined with Manipulative Reduction for Calcaneal Fractures

目的:分析跗骨窦小切口联合手法整复对跟骨骨折患者踝后足功能及骨折愈合的影响。方法:将2011年12月至2016年1月进行手术治疗的66例跟骨骨折患者按照手术方法不同分为传统组31例,观察组35例,传统组采用外侧"L"形切口钢板内固定,观察组采用跗骨窦小切口联合手法整复,术后均随访3~24个月。观察比较两组疗效,术后跟骨宽度、Bohler角和Gissane角,手术时间,骨折愈合时间及切口皮缘坏死、切口感染等并发症发生情况。结果:观察组优良率显著高于传统组;观察组术后跟骨宽度、Bohler角和Gissane角均显著优于传统组;观察组手术时间、骨折愈合时间均显著短于传统组;术后传统组并发症发生率显著高于观察组。结论:与外侧L型切口内固定相比,跗骨窦小切口联合手法整复治疗跟骨骨折,更有利于患者踝后足功能恢复和骨折愈合,可作为跟骨骨折的首选手术方案。

Objective:To analyze the effects of small incision of tarsal sinus combined with manipulation on the function of ankle-posterior foot and fracture healing in patients with calcaneal fracture.Methods:66 cases of calcaneal fractures patients treated in our hospital from December 2011 to January 2016 were divided into 31 cases in the traditional group and 35 cases in the observation group according to the different operative methods.In the traditional group,the lateral"L"shaped incision was used for internal fixation,and in the observation group,the tarsal sinus small incision combined with manipulation and internal fixation was used,all the patients were followed up for 3~24 months.The curative effect,postoperative calcaneal width,Bohler angle and Gissane angle,operative time,fracture healing time,the occurrence of complications such as incision margin necrosis,incision infection,and so on were observed and compared between the two groups.Results:The excellent rate of the observation group was significantly higher than that of the traditional group.The calcaneus width,Bohler angle and Gissane angle in the observation group were significantly better than those in the traditional group.The operative time and fracture healing time in the observation group were significantly shorter than those in the traditional group.The incidence of complications in the postoperative group was significantly higher than that in the observation group.Conclusion:Compared with the lateral L type incision internal fixation,the tarsal sinus small incision combined with manipulation for the treatment of calcaneal fracture is more beneficial to the recovery of ankle-posterior foot function and fracture healing,which can be used as the first choice for calcaneal fracture.