不同手术方式对SandersⅢ型跟骨骨折的疗效比较

The efficacy comparison of two different methods in the treatment of calcaneal fractures of Sanders typeⅢ

目的研究比较经皮撬拨复位空心螺钉与经跗骨窦入路微型锁定板内固定治疗SandersⅢ型跟骨骨折的疗效。方法选取我院收治的SandersⅢ型跟骨骨折患者72例,采用随机数字表方法将患者分为观察组和对照组,每组36例。观察组采取经皮撬拨复位空心螺钉内固定,对照组采取经跗骨窦入路微型锁定板内固定。观察两组的手术时间、术中出血量、术后并发症、Bohler角和Gissane角矫正情况,并在末次随访时进行足部功能评分判断疗效差异。结果两组手术时间比较,P>0.05;观察组术中出血量小于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05);观察组与对照组的Bohler角和Gissane角矫正情况比较,P>0.05;两组术后16个月AO-FAS踝与后足功能评分比较,P>0.05。结论两种手术方式均可满意复位,可靠固定,但是经皮撬拨复位空心螺钉内固定出血量少、并发症少。

Objective To compare the efficacy of percutaneous reduction cannulated screws and mini-locking plate internal fixation through sacral sinus approach in the treatment of calcaneal fractures of Sanders typeⅢ.Methods 72 patients with Sanders typeⅢcalcaneal fractures treated in our hospital were randomly divided into the observation group and the control group,36 cases in each group.The observation group was treated with percutaneous reduction can⁃nulated screws,while the control group was treated with mini-locking plate internal fixation through sacral sinus ap⁃proach.The operation time,intraoperative blood loss,postoperative complications,correction of Bohler angle and Gis⁃sane angle and the foot function score by the American Ankle and Surgery Association(AOFAS)Ankle and Hind Foot Function Scoring System at the last follow-up were compared between the two groups.Results There was no signifi⁃cant difference in the operation time between the two groups(P>0.05).The intraoperative blood loss in the observation group was less than that in the control group(P<0.05).The incidence of complications in the observation group was low⁃er than that in the control group(P<0.05).There was no significant difference in the correction of Bohler angle and Gis⁃sane angle between the group(P>0.05).The hindfoot function scores of the two groups at 16 months after surgery had no significant difference(P>0.05).Conclusion Both surgical methods can satisfactorily reset and fix reliably,but percuta⁃neous reduction cannulated screws has the advantages of less bleeding and fewer complications.