经跗骨窦切口与经外侧L型切口治疗跟骨骨折的疗效研究

Surgical outcomes of calcaneal fractures via tarsal sinus incision vs lateral L-shaped incision

目的研究跟骨骨折患者接受经跗骨窦切口与经外侧L型切口两种不同术式治疗的效果。方法借助随机数字表进行随机抽样,选取我院2017年1月至2018年6月期间收治的跟骨骨折患者为研究样本,其中42例患者经跗骨窦切口实施手术治疗,为研究的观察组;同时随机选取另外42例患者经外侧L型切口实施手术治疗患者作为对照;比较两组手术效果。结果跗骨窦组、L型组术后跟骨高度、跟骨宽度、跟骨长度、Bohler角、Cissane角均优于术前,P<0.05,但术后组间无明显差异,P>0.05;跗骨窦组手术后足功能AOFAS评分结果高于L型组(t=5.2678,P<0.05);跗骨窦组术后并发症发生率4.76%,L型组发生率19.05%(χ^(2)=4.0865,P<0.05)。研究随访患者术后6个月跟骨复位丢失、踝关节和距下关节退变性OA的情况,结果提示跗骨窦组患者随访6个月跟骨复位丢失率优于L型组(χ^(2)=4.200,P<0.05)。结论跟骨骨折患者接受经跗骨窦切口的手术治疗能够减轻创伤,减少术后并发症,加快患者术后恢复。

Objective To investigate the surgical outcomes of calcaneal fractures via tarsal sinus incision vs lateral L-shaped incision.Methods By using random number table,patients with calcaneal fractures admitted to our hospital between January 2017 and June 2018 were enrolled as study subjects.Among them,42 patients received surgical treatment via tarsal sinus incision(study group),and another 42 were randomly selected for surgical treatment via lateral L-shaped incision(control group).The two groups were compared for surgical outcomes.Results The postoperative calcaneal height,width and length,Bohler angle,and Cissane angle were improved compared with baseline in either group(P<0.05),but but did not differ significantly between groups(P>0.05).After surgery,the study group showed higher AOFAS score of foot function than did the control group(t=5.2678,P<0.05).The rate of postoperative complication was 4.76%in the study group vs 19.05%in the control group(χ^(2)=4.0865,P<0.05).All patients were followed up for 6 months for loss of calcaneal reduction,degenerative osteoarthritis of the ankle and subtalar joints.Fewer patients in the study group experienced loss of calcaneal reduction compared with the control group(χ^(2)=4.200,P<0.05)at the end of 6-month follow-up.Conclusion Surgical treatment of calcaneal fractures via tarsal sinus incision may result in less trauma,fewer postoperative complications,and quicker postoperative recovery.