跗骨窦入路微型钢板治疗跟骨骨折的疗效

The effect of microplate via tarsal sinus approach for treatment of calcaneal fractures

目的探讨跗骨窦入路微型钢板治疗跟骨骨折的疗效。方法将90例跟骨闭合骨折患者按照不同手术方式分为观察组和对照组,各45例。观察组采用跗骨窦入路微型钢板治疗,对照组采用经典外侧扩大L形入路联合钢板内固定治疗。结果两组患者均获得随访,时间12~30(14.29±2.15)个月。手术时间、术中出血量、全足负重时间、住院时间和骨折愈合时间观察组明显短(少)于对照组(P<0.01)。术后4个月,观察组的跟骨长度和高度、B?hler角、Gissane角、踝与后足功能较对照组明显升高(P<0.01),而跟骨宽度较对照组明显降低(P<0.01),两组踝与后足对线比较差异无统计学意义(P>0.05)。术后4个月,两组踝关节跖屈和背伸较术前明显提高(P<0.01),外翻和内翻角较术前明显降低(P<0.01),观察组的升高或者降低水平较对照组更为明显(P<0.01)。疗效优良率观察组明显高于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论跗骨窦入路微型钢板治疗跟骨骨折住院时间短,患者踝关节功能恢复快,疗效显著。

Objective To explore the efficacy of microplate via tarsal sinus approach for treatment of the patients with calcaneal fractures.Methods The 90 patients with calcaneal fractures were divided into observation group and control group according to different surgical methods.Each group had 45 patients.The observation group was treated with microplate via tarsal sinus approach,and the control group was treated with plate fixation via classic lateral extended L-shaped approach.Results All cases were followed up for 12~30(14.29±2.15)months.The operative time,intraoperative blood loss,full feet weight-bearing time,hospitalization time and fracture healing time in the observation group were significantly shorter(less)than those in control group(P<0.01).At 4 months postoperation,the calcaneal length and height,B?hler angle,Gissane angle,ankle and hindfoot function were significantly increased in the observation group than those in the control group(P<0.01),but the calcaneal width was significantly decreased in the observation group than that in the control group(P<0.01).There was no significant difference in ankle and hindfoot on line between two groups(P>0.05).At 4 months after surgery,the ankle plantarflexion and dorsiflexion were significantly increased than those before surgery(P<0.01),and the valgus and varus angles were significantly decreased than those before surgery(P<0.01),while the increasing or decreasing levels amplitude in the observation group was more obvious than those in the control group(P<0.01).The excellent and good rate in the observation group was significantly higher than those in the control group(P<0.05).The overall complication incidence rate in the observation group was lower than that in the control group(P<0.05).Conclusions Microplate with tarsal sinus approach for treatment of calcaneal fractures has the advantages of shorter hospital stay time,rapid recovery of ankle joint function,and the effect is significant.