经跗骨窦切口内固定术与经外侧“L”形切开钢板内固定术治疗Sanders Ⅱ～Ⅲ型跟骨骨折的效果比较

Transtarsal sinus incision internal fixation versus translateral L-shaped incision plate internal fixation in the treatment of patients with Sanders Ⅱ to Ⅲ calcaneal fractures

目的比较经跗骨窦切口内固定术与经外侧“L”形切开钢板内固定术治疗SandersⅡ~Ⅲ型跟骨骨折的效果。方法选取80例SandersⅡ~Ⅲ型跟骨骨折患者,随机分为治疗A组与治疗B组各40例。治疗A组采用经典的经外侧“L”形切口钢板内固定术治疗,治疗B组采用经跗骨窦切口空心钉内固定术治疗。比较2组手术效果。结果治疗B组手术出血量、术后引流量显著低于治疗A组(P<0.05)。2组术后跟骨Bohler角、Cissane角均较术前显著升高(P<0.05),但2组术前及术后跟骨Bohler角、Cissane角比较,差异无统计学意义(P>0.05)。治疗B组总并发症发生率低于治疗A组,差异有统计学意义(P<0.05);2组术后12个月Maryfand评分及优良率比较,差异无统计学意义(P>0.05)。结论经典的经外侧“L”形切口内固定术与经跗骨窦切口内固定术治疗SandersⅡ~Ⅲ型跟骨骨折的手术效果相似,但经跗骨窦切口内固定术具有出血量少、引流量少和并发症少的优点。

Objective To compare the effect of transtarsal sinus incision internal fixation and translateral L-shaped incision plate internal fixation in the treatment of patients with SandersⅡtoⅢcalcaneal fractures.Methods A total of 80 patients with SandersⅡtoⅢcalcaneal fractures were selected and randomly divided into treatment group A and treatment group B.Treatment group A was treated with classical translateral L-shaped incision plate internal fixation,while treatment group B was treated with transtarsal sinus incision internal fixation by hollow nail.Surgical effect was compared between two groups.Results The bleeding volume and drainage volume in treatment group B were significantly lower than those in treatment group A(P<0.05).The calcaneal Bohler angle and Cissane angle in both groups were significantly higher than those before operation(P<0.05),but there were no significant differences in the calcaneal Bohler angle and Cissane angle between the two groups before and after operation(P>0.05).The incidence rate of total complications in treatment group B was significantly lower than that in treatment group A(P<0.05),and there were no significant differences in Maryfand score,excellent and good rate between the two groups at 12 months after operation(P>0.05).Conclusion Classical translateral L-shaped incision internal fixation is similar to transtarsal sinus incision internal fixation in the treatment of SandersⅡtoⅢcalcaneal fractures,but transtarsal sinus incision internal fixation has the advantages of less bleeding,less drainage volume and fewer complications.