跗骨窦切口组合式内固定微创治疗SandersⅢ型跟骨骨折的效果

Effect of minimally invasive treatment with tarsal sinus incision and combined internal fixation on Sanders Ⅲ calcaneal fracture

目的探讨经跗骨窦切口采用多种内植物组合固定微创治疗SandersⅢ型跟骨骨折的手术方法和临床效果。方法选择我科36例(41足)SandersⅢ型跟骨骨折患者为研究对象,患者均采用经跗骨窦切口组合植入锁定板、锁定钉、空心钉及克氏针等内固定物手术治疗,分析患者手术治疗效果。结果 36例患者平均随访时间为13.4个月。患者术后切口均顺利愈合,未有感染及皮肤坏死现象出现;骨折平均愈合时间为3.9个月。术后患者的Bohler角、Gissane角均显著优于术前(P<0.05)。该手术治疗优良率为95.12%。结论经跗骨窦切口组合固定微创治疗SandersⅢ型跟骨骨折能直接显露跟骨后关节面,操作简单,切口并发症少,复位固定可靠,值得临床推广。

Objective To investigate the surgical method and clinical effect of minimally invasive treatment with tarsal sinus incision and multiple implant combinations on Sanders Ⅲ calcaneal fracture.Methods Thirty-six patients(41 feet)with Sanders Ⅲ calcaneal fracture in our department were selected as study objects.All patients were treated with implantation of locking plate,locking nail,hollow nail and Kirschner wire through tarsal sinus incision.The effect of surgical treatment was investigated.Results The average follow-up time of 36 patients was 13.4 months.All incisions healed smoothly without infection or skin necrosis.The average healing time of fracture was 3.9 months.The angle of Bohler and Gissane of the patients after operation were significantly better than those before operation(P<0.05).The excellent and good rate of treatment of operation was 95.12%.Conclusion Minimally invasive treatment of Sanders Ⅲ calcaneal fracture through tarsal sinus incision and combined internal fixation can directly expose the posterior articular surface of calcaneus,which is simple to operate,with less incision complications,reliable reduction and fixation,and is worthy of clinical promotion.