“U”型外侧切口结合锁定钢板内固定治疗跟骨粉碎性骨折的效果分析

Effect of Type“U”Lateral Incision Combined with Locking Plate Internal Fixation in the Treatment of Calcaneal Comminuted Fracture

目的探讨"U"型外侧切口结合锁定钢板内固定治疗跟骨粉碎性骨折的临床效果。方法选取我院2015年6月至2018年6月收治的跟骨粉碎骨折患者52例进行回顾性分析,依据手术切口的不同分为两组,研究组(n=26)接受"U"型外侧切口结合锁定钢板内固定治疗,对照组(n=26)接受"L"型切口结合锁定钢板内固定治疗。比较两组患者的手术一般指标、Bhler角及Gissane角、美国矫形足踝协会(AOFAS)足部评分及并发症发生率。结果研究组的手术时间、术中出血量、骨折愈合时间均明显低于对照组(P<0.05);术前两组的Bhler角及Gissane角无明显差异(P>0.05),术后均较术前有所改善,且研究组明显优于对照组(P<0.05);研究组AOFAS评分及优良率明显优于对照组(P<0.05),且并发症发生率明显低于对照组(P<0.05)。结论相对于传统的"L"型切口,采用改良后的"U"型外侧切口结合锁定钢板内固定治疗,可保证充足的手术视野和关节面复位效果,减少手术创伤及骨折并发症,总体安全性与稳定性较好,术后效果更优。

Objective To explore the effect of type“U”lateral incision combined with locking plate internal fixation in the treatment of calcaneal comminuted fracture.Methods From June 2015 to June 2018,52 patients with calcaneal comminuted fracture were retrospectively analyzed.They were divided into two groups according to the different incisions.The patients receiving U-shaped lateral incision combined with locking plate internal fixation were set up as the study group(n=26),while the patients receiving L-shaped incision combined with locking plate internal fixation were set up as the control group(n=26).The general surgical indicators,Bhler angle,Gissane angle,the AOFAS score and the incidence of complications were compared between the two groups.Results The operation time,intraoperative blood loss and fracture healing time of the study group were significantly lower than those of the control group(P<0.05).The Bhler angle and Gissane angle of the two groups before operation had no statistical difference(P>0.05).The Bhler angle and Gissane angle of the two groups after operation were improved compared with those before operation,and the Bhler angle and Gissane angle of the study group after operation were significantly better than those of the control group(P<0.05).The average AOFAS score and the excellent and good rate in the study group were significantly better than those in the control group(P<0.05).The incidence of complications in the study group was significantly lower than that in the control group(P<0.05).Conclusion Compared with the traditional“L”incision,the modified"U"lateral incision combined with locking plate internal fixation can ensure sufficient surgical field and joint reduction effect,reduce surgical trauma and fracture complications,and improve the overall safety and stability,and ultimately improve the prognosis of patients.