经跗骨窦切口复位经皮钢板内固定治疗SandersⅡ Ⅲ型跟骨骨折

A feasibility report on the treatment of SandersⅡandⅢcalcaneal fractures by reduction through tarsal sinus incision and percutaneous plate internal fixation

目的探讨经跗骨窦切口复位经皮钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折可行性。方法选取茂名市中医院2019年6月—2020年6月诊治的SandersⅡ、Ⅲ型跟骨骨折患者70例,随机分为对照组和观察组,每组35例。对照组患者实施“L”形切口复位内固定术,观察组实施经跗骨窦切口复位经皮钢板内固定术,比较手术前及手术后3个月2组患者的跟骨Gissane角及Bohler角;住院时间、手术时间、骨折愈合时间及术后引流量;术后并发症发生率。结果2组患者手术前跟骨Gissane角及Bohler角差异无统计学意义(P>0.05);手术后3个月,2组患者的跟骨Gissane角及Bohler角均恢复正常,且组间对比无明显差异(P>0.05)。观察组患者手术时间及骨折愈合时间较对照组无明显差异(P>0.05)。观察组患者住院时间及术后引流量较对照组低(P<0.05)。观察组患者并发症发生率为11.43%低于对照组的31.43%(P<0.05)。结论经跗骨窦切口复位经皮钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折,可有效恢复患者的跟骨Gissane角及Bohler角,缩短住院时间,减少术后引流量,降低并发症发生率,有利于患者尽快恢复。

Objective To explore the feasibility of treating Sanders Ⅱ ⅱand ⅲ calcaneal fractures by reduction through tarsal sinus incision and percutaneous plate fixation.Methods 70 cases of Sanders Ⅱ ⅱ and ⅲ calcaneal fractures treated in our hospital from June 2019 to June 2020 were randomly divided into control group and observation group,with 35 cases in each group.Patients in the control group were treated with L-shaped incision reduction and internal fixation,while patients in the observation group were treated with tarsal sinus incision reduction and percutaneous plate internal fixation.The Gissane angle and Bohler angle of calcaneus of the two groups were compared before and 3 months after operation.Hospital stay,operation time,fracture healing time,postoperative drainage volume and postoperative complication rate.Results There was no significant difference between the two groups in Gissane angle and Bohler angle of calcaneus before operation(P>0.05).Three months after operation,the Gissane angle and Bohler angle of calcaneus of the two groups returned to normal,but there was no significant difference between the two groups(P>0.05).There was no significant difference in operation time and fracture healing time between observation group and control group(P>0.05).The hospitalization time and postoperative drainage volume of patients in observation group were lower than those in control group(P<0.05).The incidence of complications in the observation group(11.43%)was lower than that in the control group(31.43%),P<0.05.Conclusion The tarsal sinus incision reduction and percutaneous plate internal fixation for Sanders Ⅱ ⅱ and ⅲ calcaneal fractures can effectively restore Gissane angle and Bohler angle of calcaneus,shorten the hospital stay,reduce postoperative drainage,reduce the incidence of complications,and help patients recover as soon as possible.