经跗骨窦小切口空心钉内固定术和外侧“L”形切口钢板内固定术治疗跟骨骨折的差异

Difference between the Cannulated Screw Internal Fixation Performed by Tarsal Sinus Small Incision and the Plate Internal Fixation Performed by Lateral “L” Type Incision for Treatment of Calcaneal Fractures

目的:探讨经跗骨窦小切口空心钉内固定术和外侧"L"形切口钢板内固定术治疗跟骨骨折的差异。方法:回顾性分析2016年3月-2017年3月在本院治疗的40例跟骨骨折患者的临床资料。依据手术方法不同分为观察组和对照组,各20例。观察组接受经跗骨窦小切口空心钉内固定手术,对照组接受外侧"L"形切口钢板内固定术。比较两组手术时间、术中出血量、术后住院时间、骨折愈合时间等手术相关指标,比较两组术后并发症、Bohler角、Gissane角和跟骨中部宽度、Maryfand评分及术后足部功能恢复情况。结果:观察组手术时间、术中出血量、术后住院时间均少于对照组(P<0.05),但两组骨折愈合时间比较差异无统计学意义(P>0.05);观察组并发症发生率低于对照组(P<0.05);术后,两组Bohler角、Gissane角及跟骨中部宽度均大于术前(P<0.05),但两组比较差异均无统计学意义(P>0.05);术后1年,观察组Maryfand评分高于对照组(P<0.05),观察组足部功能恢复优良率为75.00%,高于对照组的60.00%(P<0.05)。结论:同外侧"L"形切口钢板内固定术相比,经跗骨窦小切口空心钉内固定术患者术后恢复效果更佳,不仅减少了患者手术时间、术中出血量以及术后住院时间,而且能够降低患者术后并发症的发生率,有助于提高患者术后足部功能的恢复。

Objective:To explore the difference between the cannulated screw internal fixation performed by tarsal sinus small incision and the plate internal fixation performed by lateral“L”type incision for treatment of calcaneal fractures.Method:The clinical data of 40 cases of calcaneal fractures treated in our hospital from March 2016 to March 2017 were retrospectively analyzed.According to different surgical methods,they were divided into observation group and control group,20 cases in each group.The observation group received cannulated screw internal fixation performed by tarsal sinus small incision,while the control group received the plate internal fixation performed by lateral“L”type incision.The operation time,intraoperative bleeding volume,postoperative hospitalization time and fracture healing time between the two groups were compared,the postoperative complications,Bohler angle,Gissane angle,the width of the middle part of the calcaneus,Maryfand score and postoperative foot function recovery between the two groups were compared.Result:The operation time,intraoperative bleeding volume and postoperative hospitalization time in observation group were less than those of control group(P<0.05),but the fracture healing time of two groups was compared,the difference was not statistically significant(P>0.05).The incidence of complications in observation group was lower than that of control group(P<0.05).After operation,the Bohler angle,Gissane angle and the width of the middle part of the calcaneus in two groups were all larger than those of before operation(P<0.05),but the two groups were compared,the differences were not statistically significant(P>0.05).1 year after operation,the Maryfand score of observation group was higher than that of control group(P<0.05),the excellent and good rate of foot function recovery in observation group was 75.00%,which was higher than 60.00%of control group(P<0.05).Conclusion:Compared with the plate internal fixation performed by lateral“L”type incision,the postoperative recovery effects of patients with the cannulated screw internal fixation performed by tarsal sinus small incisionis better,it can not only reduce the operation time,intraoperative bleeding volume and postoperative hospitalization time,but also reduces the incidence of postoperative complications and helps to improve the recovery of postoperative foot function.