跗骨窦切口微创手术治疗跟骨骨折疗效分析

Curative Effect Analysis of Calcaneal Fracture with Minimally Invasive Operation Through Tarsal Sinus Incision

目的研究运用跗骨窦切口微创治疗跟骨骨折的临床疗效。方法收集20例闭合性跟骨骨折患者的临床资料,Sanders分型:Ⅱ型9例,Ⅲ型11例,对术前、术后3天、术后3个月的跟骨宽度、Bohler角、Gissane角进行统计学分析,应用美国足踝外科协会评分(AOFAS评分)标准评定疗效。结果20例患者切口均无切口并发症,与术前相比,术后3天和末次随访时跟骨宽度明显降低,Bohler角和Gissane角明显增大,差异均有统计学意义(P<0.05)。术后3天与术后3个月随访时相比跟骨宽度、Bohler角和Gissane角的变化结果差异无统计学意义(P>0.05),AOFAS评分:优10例,良7例,可3例。优良率85%。结论微创跗骨窦小切口内固定治疗SandersⅡ、Ⅲ型跟骨骨折具有切口并发症少,临床疗效好等特点,适合临床推广。

Objective To investigate the effect of minimally invasive treatment of calcaneal fractures through tarsal sinus incision.Methods 20 cases of closed calcaneal fracture were collected. Sanders classification: 9 cases of Type Ⅱ, 11 cases of type Ⅲ.The calcaneal width, Bohler Angle and Gissane angle before operation, 3 days after operation and 3 months after operation were statistically analyzed. The American Foot and Ankle Surgical Association’s ankle-foot scoring system was used to assess the outcome.Results All the incisions of 20 patients healed with no complications. The calcaneus width decreased, and Bohler Angle and Gissane angle increased significantly. And the difference was statistically significant(P<0.05). There was no significant difference in calcaneal width,Bohler Angle and Gissane angle 3 days and 3 months after operation(P>0.05). In the American Academy of Orthopaedic Foot and Ankle Surgery ankle-foot score, there were 10 excellent cases, 7 good cases, and 3 fair cases. There was 85%excellent rate.Conclusion Minimally invasive internal fixation of Sanders Type Ⅱ and Ⅲ calcaneal fractures has the characteristics of less incision complications and good clinical effect. So it is suitable for clinical promotion.