微创跗骨窦小切口与传统L形切口治疗跟骨骨折患者的疗效比较

Comparison of the Curative Effect of Minimally Invasive Sinus Tarsi Small Incision and Traditional L-shaped Incision in the Treatment of Calcaneal Fractures

目的对比跟骨骨折行传统L形切口、微创跗骨窦小切口内固定术治疗的疗效。方法回顾性选取2017年1月—2019年12月94例跟骨骨折患者入组研究,根据治疗方法依次分为传统组47例和微创组47例。传统组行传统“L”型切口内固定术治疗,微创组行微创跗骨窦小切口内固定术治疗。将手术效果(手术时间、术中出血量、骨折愈合时间及住院时间)、骨折复位效果(跟骨Gissane角和Bohler角)、关节功能(Kofoed、AOFAS评分)和术后并发症的发生率作为该研究的主要观察指标。结果微创组患者平均手术时间、骨折愈合时间及住院时间均短于传统组,术中出血量少于传统组,差异有统计学意义(P<0.05)。治疗后,两组跟骨Gissane角、Bohler角、Kofoed评分、AOFAS评分比较,均差异无统计学意义(P>0.05)。在术后并发症的发生率上,传统组、微创组依次为21.28%、6.38%,两组比较,差异有统计学意义(χ^2=4.374,P=0.036)。结论微创术与传统术治疗跟骨骨折所取得的骨折复位效果和关节功能改善效果相当,但微创术下患者出血量少、骨折愈合快,术后并发症少,且康复进程快。

Objective To compare the curative effect of traditional L-shaped incision and minimally invasive sinus tarsi small incision internal fixation for calcaneal fractures.Methods Retrospectively enrolled 94 patients with calcaneal fractures from January 2017 to December 2019.According to the treatment method,they were divided into 47 cases in the traditional group and 47 cases in the minimally invasive group.The traditional group received traditional"L"-shaped incision internal fixation,and the minimally invasive group received minimally invasive sinus tarsi small incision internal fixation.The surgical effect(operation time,intraoperative blood loss,fracture healing time and hospitalization time),fracture reduction effect(calcaneal Gissane angle and Bohler angle),joint function(Kofoed,AOFAS score),and the incidence of postoperative complications were taken as the main observation indicators of this study.Results The average operation time,fracture healing time and hospital stay of patients in the minimally invasive group were shorter than those in the traditional group,and intraoperative blood loss was less than in the traditional group,the difference was statistically significant(P<0.05).After treatment,there was not statistically significant difference between the two groups of calcaneal Gissane angle,Bohler angle,Kofoed score,and AOFAS score(P>0.05).The incidence of postoperative complications was 21.28%in the traditional group and 6.38%in the minimally invasive group.The difference between the two groups was statistically significant(χ^2=4.374,P=0.036).Conclusion Minimally invasive surgery and traditional surgery for the treatment of calcaneal fractures achieve the same fracture reduction effect and joint function improvement effect.However,patients undergoing minimally invasive surgery have less blood loss,faster fracture healing,fewer postoperative complications,and faster recovery.It is more worthy of clinical application.