经跗骨窦入路结合型解剖板治疗SandersⅡ/Ⅲ型跟骨骨折

Sinus Tarsi Approach Combined with Anatomical Plate for Sanders Ⅱ/Ⅲ Calcaneal Fractures

目的探讨经跗骨窦切口联合跟骨结合型微创解剖板治疗SandersⅡ/Ⅲ型跟骨骨折的短期临床疗效。方法回顾性研究分析自2016年6月至2018年6月我院骨科中心收治的18例(19足)闭合性跟骨骨折患者,其中男11例,女7例;年龄范围22-65岁,平均(38.1±5.6)岁。Sanders分型:Ⅱ型8足,Ⅲ型11足。全部患者均采用经跗骨窦入路,联合使用跟骨结合型微创解剖板进行治疗。结果本组病例术后均获得随访,随访时间12-18个月,平均(13.5±1.5)个月。根据美国足踝外科协会(American orthopaedic foot and ankle society,AOFAS)踝-后足评分标准对患足功能进行评价,优16足,良2足,可1足,优良率94.7%。结论经跗骨窦切口入路联合跟骨结合型微创解剖板治疗SandersⅡ/Ⅲ型跟骨骨折,可有效恢复跟骨的形态,有利于足踝功能地恢复,可作为SandersⅡ/Ⅲ型跟骨骨折手术治疗的一种选择。

Objective To explore the short-term clinical effect of transtarsal sinus incision combined with calcaneal mini-anatomical plate in the treatment of Sanders typeⅡ/Ⅲcalcaneal fractures.Methods A retrospective study was conducted to analyze the clinical data of 18 patients(19 cases)with closed calcaneal fracture treated by tarsal sinus approach combined with calcaneal wound anatomical plate from the orthopaedic center of People’s Hospital Affiliated to Hubei University of Medicine from June 2016 to June 2018.There were 12 males(1 bilateral calcaneal fracture),7 females.The age ranged from 22 to 65 years,with an average of(38.1±5.6)years.Sanders classification:8 cases of typeⅡand 11 cases of typeⅢ.Transtarsal sinus approach and calcaneal combined minimally invasive anatomical plate were used for internal fixation.Results The patients were followed up for 12 to 18 months,with an average of(13.5±1.5)months.According to the foot function,the ankle-hind foot scoring criteria of the American orthopaedic foot and ankle society(AOFAS)were used:There were excellent in 16 cases,good in 2 cases,fair in 1 case,the excellent,and good rate was 94.7%.Conclusion In the treatment of Sanders typeⅡandⅢcalcaneal fractures,transtarsal sinus incision combined with calcaneal combined minimally invasive anatomical plate can effectively restore the morphological characteristics of calcaneus and facilitate the recovery of ankle function.Its prognosis is good,and it can be used as a surgical method for Sanders typeⅡ/Ⅲcalcaneal fractures.