两种不同内固定方案治疗跟骨骨折的效果对比

Comparison of the effects of two different internal fixation schemes on calcaneal fractures

目的对比两种不同内固定方案治疗跟骨骨折患者的效果。方法 70例跟骨骨折患者,随机分为对照组和观察组,每组35例。对照组采取传统外侧L型切口内固定治疗,观察组采取跗骨窦小切口内固定治疗。比较两组患者术中出血量、手术时间、住院时间、骨折愈合时间、术后1个月踝-后足评分系统(AOFAS)评分、术后2 d视觉模拟评分法(VAS)评分以及治疗前后Bohler角、Gissane角。结果观察组患者术中出血量(43.29±5.46)ml少于对照组的(60.83±5.49)ml,手术时间(1.12±0.32)h、住院时间(5.51±0.70)d均短于对照组的(1.68±0.40)h、(8.48±0.86)d,差异均具有统计学意义(P<0.05)。两组骨折愈合时间比较,差异无统计学意义(P>0.05)。两组患者Bohler角、Gissane角比较,差异均无统计学意义(P>0.05)。两组患者术后1个月AOFAS评分(92.13±4.25)分高于对照组的(86.47±3.24)分,术后2 d VAS评分(2.43±0.29)分低于对照组的(4.86±0.64)分,差异均具有统计学意义(P<0.05)。结论对跟骨骨折患者选择跗骨窦小切口内固定手术治疗,可取得良好的治疗效果,患者的创伤性更小,更有利于恢复足踝功能,提高治疗效果。

Objective To compare the effects of two different internal fixation schemes on calcaneal fractures. Methods A total of 70 patients with calcaneal fractures were divided into control group and observation group, with 35 cases in each group. The control group was treated with traditional lateral L-incision internal fixation, and the observation group was treated with internal fixation of small tarsal sinus incision. Both groups were compared in terms of intraoperative blood loss, operation time, hospitalization time, fracture healing time,American Orthopedic Foot and Ankle Society(AOFAS) score at 1 month after surgery, visual analogue scale(VAS) score at 2 d after surgery, and Bohler angle and Gissane angle before and after treatment. Results The intraoperative blood loss(43.29±5.46) ml of the observation group was less than(60.83±5.49) ml of the control group, and the operation time(1.12±0.32) h and hospitalization time(5.51±0.70) h were shorter than(1.68±0.40) h and(8.48±0.86) d of the control group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in fracture healing time between the two groups(P<0.05). There was no statistically significant difference in Bohler angle and Gissane angle between the two groups(P>0.05). The AOFAS score(92.13±4.25) points of the observation group was higher than(86.47±3.24) points of the control group at 1 month after surgery, and the VAS score(2.43±0.29) points of the control group was lower than(4.86±0.64) points of the control group at 2 d after surgery. All the differences were statistically significant(P<0.05).Conclusion For patients with calcaneal fractures, internal fixation of small tarsal sinus incision can be used to achieve good therapeutic results. This treatment is less traumatic, and is more conducive to restoring the function of the ankle and improving the therapeutic effect.