跗骨窦切口治疗跟骨骨折的手术方法和疗效分析

目的总结经跗骨窦入路微创切口,结合闭合复位技术治疗Sanders分型Ⅱ型、Ⅲ型的跟骨骨折的手术方法和疗效.方法 2014年1月至2016年12月期间28例采用跗骨窦入路钢板或/和螺钉固定相结合治疗跟骨骨折,随访并对其临床效果进行分析评价.结果随访28例,随访时间6~24个月,其中优18例,良6例,可4例,差0例,优良率85.71%.4例患者术后有外侧壁不适,1例有行走疼痛,在8个月时取出内固定,无1例发生切口感染、骨髓炎以及皮肤坏死等严重并发症.结论采用跗骨窦入路微创治疗Sanders分型Ⅱ型、Ⅲ型骨折,并发症低,术后疗效满意.

Objective To explore the efficacy of internal fixation in the treatment of calcaneum fractures via the sinus tarsi approach. Methods From January 2014 to December 2016,28 cases of calcaneal fracture were treated with tarsal sinus approach plate or/and screw fixation. The clinical effect was analyzed and evaluated. Results All the patients were followed up for a mean period of 11.3 months(range 6~24 months). The fractures were completely healed. According to the Maryland Foot Scores,the operative effect was excellent in 18 feet,good in 6 feet,fair in 4 feet, and poor in 0 foot.The excellent and good rate was 85.71%(24/28).The postoperative width of the calcaneum,B?hler angle,and Gissane angle were significantly improved than before operation(P=0.000). Conclusion Open reduction and internal fixation via sinus tarsi approach is a simple and effective method for minimally invasive treatment of Sanders type Ⅱ and Ⅲ intra-articular calcaneum fractures.