关节镜辅助下轴向螺钉内固定术治疗Sanders-2型跟骨骨折疗效观察

Clinical effect of arthroscopically-assisted axial screw fixation in the treatment of Sanders-2 calcaneal fractures

目的探讨关节镜辅助下轴向螺钉内固定术治疗Sanders-2型跟骨骨折的临床疗效。方法将50例Sanders-2型跟骨骨折患者按照随机数字表法分为研究组与对照组,各25例。研究组给予关节镜辅助下轴向螺钉内固定术治疗,对照组给予传统切开复位内固定术治疗。术后观察3个月。比较两组手术时间、住院时间、骨折愈合时间、术前与术后3个月末两组Bohler角、Gissane角度数及跟骨高度、宽度,以及两组Maryland足功能评分、手术疗效。结果研究组手术时间、住院时间及骨折愈合时间均显著短于对照组(P<0.05或0.01)。术后3个月末两组Bohler角及Gissane角度数均较术前显著增大(P<0.01),研究组较对照组增大更显著(P<0.05或0.01)。术后3个月末研究组跟骨高度显著>术前(P<0.01),两组跟骨宽度均显著>术前(P<0.01),两组间比较差异无统计学意义(P>0.05)。术后3个月末两组Maryland足功能评分均较术前显著升高(P<0.01),研究组较对照组升高更显著(P<0.01)。研究组手术治疗总有效率显著高于对照组(P<0.05),并发症发生率显著低于对照组(P<0.05)。结论关节镜辅助下轴向螺钉内固定术治疗Sanders-2型跟骨骨折效果显著,能有效促进患者足踝功能恢复,安全性较高,值得临床推广应用。

Objective To investigate the clinical effect of arthroscopically-assisted axial screw fixation in the treatment of Sanders-2 calcaneal fractures.Methods A total of 50 patients with Sanders-2 calcaneal fractures were randomly divided into observation group and control group,25 cases each.The observation group was treated with arthroscopically-assisted axial screw internal fixation,and the control group was treated with traditional open reduction and internal fixation,patients were bserved for 3 months after operation.The operation time,hospital stay,and fracture healing time were compared between the two groups.The Bohler angle,Gissane angle and the height and width of the calcaneus were compared before and at the end of 3 months after the operation.At the end of 3 months after operation,the Maryland foot function scores were compared between the two groups,and the surgical effects of the two groups were compared.Results The operation time,hospitalization time and fracture healing time in observation group were shorter than those in control group(P<0.05 or 0.01).At the end of 3 months after operation,the Bohler angle and Gissane angle in the two groups were significantly increased compared with before treatment(P<0.01),and the increase in the study group was more significant than that in the control group(P<0.05 or 0.01).At the end of 3 months after operation,the height of the calcaneus in the study group was significantly greater than that before the operation(P<0.01),and the width of the calcaneus in the two groups was significantly greater than that before the operation(P<0.01).There was no significant difference between the two groups(P>0.05).At the end of 3 months after operation,the Maryland scores of the two groups were significantly higher than those before the operation(P<0.01),and the increase in the study group was more significant than that of the control group(P<0.01).The total effective rate of surgical treatment in the study group was significantly higher than that in the control group(P<0.05),and the incidence of complications was significantly lower than in the control group(P<0.05).Conclusions The curative effect of arthroscopically-assisted axial screw fixation is good on Sanders-2 calcaneal fractures,which can improve ankle function,has high safety,and is worthy of clinical application.