跗骨窦微创切口与外侧L形切口治疗跟骨骨折的疗效对比研究

A comparative study of the efficacy of minimally invasive sinus tarsal incision and lateral "L" incision in the treatment of calcaneal fractures

目的探讨经跗骨窦微创切口与传统L形切口治疗跟骨骨折的效果。方法回顾性分析2016年4月-2019年12月间收治的60例跟骨骨折病例,根据手术入路不同将其分为观察组(跗骨窦切口,n=30)与对照组(L形切口,n=30)。统计分析两组一般资料、手术时间、术中出血量、骨折愈合时间,以及末次随访踝-后足AOFAS (American Orthopaedic Foot and Ankle Society)评分、疼痛视觉模拟评分(visual analogue scale,VAS)等。结果两组一般资料、骨折类型、随访时间无统计学差异(P>0.05);观察组手术时间大于对照组,差异有统计学意义(P <0.05);观察组术中出血量小于对照组,差异有统计学意义(P <0.05);观察组骨折愈合时间、末次随访AOFAS评分、VAS评分与对照组比较无统计学意义(P>0.05);观察组术后未出现切口皮缘坏死以及距下关节创伤性关节炎等并发症,而对照组术后出现3例切口皮缘坏死,2例距下关节创伤性关节炎。结论经跗骨窦微创切口内固定治疗跟骨骨折可获得与经外侧L形切口相同的疗效,但并发症发生率更低。

Objective Compare the efficacy of minimally invasive incision between the sinus tarsal and traditional L incision in the treatment of calcaneal fractures.Methods A retrospective analysis of 60 cases with calcaneal fractures admitted from April 2016 to December 2019 were divided into observation group(sinus tarsi incision,n=30)and control group(L according to different surgical approaches Shape incision,n=30).The general information,operation time,intraoperative bleeding,fracture healing time,and AOFAS(American Orthopaedic Foot and Ankle Society)scores and visual analogue scale(VAS)of pain in the two groups were statistically analyzed.Results There was no significant difference in general information,fracture types,and follow-up time between the two groups(P>0.05);the operation time of the observation group was longer than that of the control group,and the difference was statistically significant(P<0.05);the intraoperative blood loss in the observation group was less than that of the control group.The difference was statistically significant(P<0.05);there was no statistical difference between the fracture healing time,final follow-up AOFAS score,and the VAS score(P>0.05);the observation group had no wound skin necrosis or distance complications of lower joint traumatic arthritis occurred.In the control group,3 cases of wound skin necrosis occurred after operation,and 2 cases of subtalar joint traumatic arthritis occurred in following-up.Conclusion A minimally invasive incision through the sinus tarsal and internal fixation for the treatment of calcaneal fractures can achieve the same curative effect as the lateral L incision,but the incidence of complications is lower.