跗骨窦小切口结合手法整复和跟骨外侧L型切口治疗跟骨关节内骨折的临床疗效

Clinical Effect of Small Incision of Sacral Sinus Combined with Manipulation and Lateral Incision of the Calcaneus for the Treatment of Intra-articular Calcaneal Fractures

目的探索跗骨窦小切口结合手法整复和跟骨外侧L型切口治疗跟骨关节内骨折的临床疗效。方法方便选取2017年4月—2018年4月期间该院跟骨关节内骨折60例患者(实施奇偶数分组模式),对照组的30例患者进行跟骨外侧L型切口治疗,观察组的30例患者进行跗骨窦小切口结合手法整复治疗,随后对比两组Bohlers角差值、跟骨中部宽度差值、Gissane角差值、切口长度、并发症发生率、骨折愈合时间、术中出血量、手术时间。结果观察组骨折愈合时间(7.45±1.33)周、术中出血量(25.78±2.61)mL、手术时间(61.48±3.22)min、切口长度(4.85±1.33)cm、并发症发生率(3.33%)、Gissane角差值(121.15±6.94)°、Bohlers角差值(31.28±3.55)°、跟骨中部宽度差值(26.38±3.23)mm、Kofoed评分(92.45±2.35)分、Maryland评分(93.16±2.41)分、优良率(96.67%)均优于对照组(t=3.235 5、31.973 9、15.013 7、12.320 3、9.016 7、t=5.514 8、11.348 2、13.344 0,56.258 4、15.423 5,χ2=10.258 2;P<0.05)。结论对跟骨关节内骨折患者实施跗骨窦小切口结合手法整复效果显著。

Objective To investigate the clinical effect of small incision of the sinus sinus combined with manual manipulation and lateral incision of the calcaneus for the treatment of intra-articular calcaneal fractures.Methods 60 patients with intra-articular fractures of the calcaneus were enrolled in our hospital from April 22,2017 to April 22,2018.The patients in the control group were treated with L-shaped incision of the lateral calcaneal.30 patients in the observation group underwent small incision of the sacral sinus combined with manual manipulation,and then compared the difference between the two groups of Bohlers angle,the width of the middle part of the calcaneus,the difference of the Gissane angle,the length of the incision,the incidence of complications,the time of fracture healing,The amount of intraoperative blood loss and operation time.Results The fracture healing time of the observation group was (7.45±1.33) weeks,intraoperative blood loss (25.78±2.61)mL,operation time (61.48±3.22) min,incision length (4.85±1.33) cm,and complication rate (3.33%),Gissane angle difference (121.15±6.94)°,Bohlers angle difference (31.28±3.55)°,middle calcane width difference (26.38±3.23)mm,Kofoed score (92.45±2.35)points,Maryland score (93.16±2.41)points,the excellent and good rate (96.67%) were better than the control group (t=3.235 5,31.973 9,15.013 7,12.320 3;χ^2=9.016 7,t=5.514 8,11.348 2,13.344 0,56.258 4,15.423 5;χ^2=10.258 2;P<0.05).Conclusion In the treatment of patients with intra-articular calcaneal fractures,the small incision of the sacral sinus combined with manual manipulation is effective.