经跗骨窦入路联合应用微型钢板与内侧支撑螺钉治疗跟骨关节内骨折早期疗效

Early effects of intra-articular fracture of calcaneal joint with a combined treatment of miniature steel plate and inner support screw through tarsal sinus

目的:经跗骨窦入路联合应用微型钢板与内侧支撑螺钉治疗跟骨关节内骨折的早期临床疗效。方法:取2018年10月—2019年6月接收46例闭合性跟骨关节内骨折患者,应用经跗骨窦入路联合应用微型钢板与内侧支撑螺钉内固定治疗,分析总住院天数、手术时间、术中出血量、贝勒氏恢复情况与早期并发症发生情况。结果:总住院天数5~12 d,平均(7±0.4)d,手术时间72~121 min,平均(90.0±2.1)min,术中出血量150~300 mL,平均(189.0±5.4)mL,住院天数5~12 d,平均(7.0±0.4)d;术后复查X线,其中有2跟骨贝勒氏角不满意,无1例术后发生皮肤坏死或感染等并发症,整体疗效满意。结论:选择应用跗骨窦入路联合应用微型钢板与内侧支撑螺钉治疗跟骨关节内骨折用时短,出血量少,可术中直视下复位,术后复位效果满意,术后术并发症少,是一种治疗跟骨关节内骨折的有效方法。

Objective:To evaluate the early effects of treatment of intra-articular fracture of calcaneal joint with a combined treatment of miniature steel plate and inner support screw through tarsal sinus.Methods:46 patients with closed intra-articular calcaneal fractures hospitalized between October 2018 and June 2019 were treated with a combined approach of miniature steel plate and inner support screw through tarsal sinus.The hospitalization days,operation duration,intraoperative blood loss,Bellerby's recovery and early complications were analyzed.Results:The total length of stay ranges from 5.0 to 12.0 days,with an average of 7.0±0.4 days,also the operation duration ranges from 72.0 to 121.0 minutes,with an average of 90.0±2.1 minutes.The intraoperative blood loss and the average Bellerby's number are 150-300 mL and 189.0±5.4 mL respectively.The post-operation X-ray results show that 2 calcaneal Bellerby's angle are not optimal.And no complications such as skin necrosis or infection occurred after operation.The overall effect was satisfactory.Conclusion:The combination of miniature steel plate and inner support screw through tarsal sinus in the treatment of intra-articular calcaneal fractures is effective,with its short operation duration,small amount of bleeding,reduction under direct vision during operation,satisfactory reduction effect and small percentage postoperative complications.