两种不同的切口治疗跟骨骨折的临床对比分析

Clinical Comparative Analysis of Two Different Incisions in the Treatment of Calcaneal Fractures

目的:比较跗骨窦与外侧"L"形入路内固定治疗跟骨骨折的效果。方法:回顾性分析2013年1月-2020年1月九江市第一人民医院骨科收治的54例跟骨骨折患者的临床资料,其中,采取经跗骨窦入路内固定治疗者27例标记为观察组,经外侧"L"形入路内固定治疗者27例标记为参照组,比较两组患者围术期情况、不良事件发生率以及术后随访情况。结果:观察组的术前准备时间(3.86±0.62)d、手术时间(58.56±13.61)min、术中出血量(30.31±6.27)mL及术后住院时间(7.24±2.13)d均明显少于参照组(7.64±1.76)d、(75.72±15.46)min、(59.55±10.78)mL、(10.63±2.03)d,差异均有统计学意义(P<0.05);观察组的不良事件发生率为3.70%(1/27),低于参照组的25.93%(7/27),差异有统计学意义(P<0.05);术后12个月回访,观察组患者的疼痛发生率低于参照组,差异有统计学意义(P<0.05)。结论:与外侧"L"形入路内固定治疗相比,采用跗骨窦入路插入锁定钢板治疗跟骨骨折更为安全、有效,值得临床推广及应用。

Objective:To compare the effects of internal fixation between sinus tarsi and lateral "L" shaped approach in the treatment of calcaneal fractures.Method:A retrospective analysis of the clinical data of 54 patients with calcaneal fractures admitted to the Department of Orthopedics,Jiujiang NO.1 People’s Hospital from January 2013 to January 2020,of which 27 cases were treated with internal fixation via the sinus tarsi approach were marked as in the observation group,27 patients treated with internal fixation via the lateral "L" shaped approach were marked as the reference group.The perioperative situation,the incidence of adverse events,and the postoperative follow-up were compared between the two groups.Result:The preoperative preparation time (3.86±0.62) d,operation time (58.56±13.61) min,intraoperative blood loss (30.31±6.27) mL and postoperative hospital stay (7.24±2.13) d of the observation group were significantly less than (7.64±1.76) d,(75.72±15.46) min,(59.55±10.78) mL,(10.63±2.03) d of the reference group,the differences were statistically significant (P<0.05);the incidence of adverse events in the observation group was 3.70% (1/27),lower than 25.93% (7/27) of the reference group,the difference was statistically significant (P<0.05);12 months after surgery,the incidence of pain in the observation group was lower than that in the reference group,the difference was statistically significant (P<0.05).Conclusion:Compared with the internal fixation treatment through the lateral "L" shaped approach,the sinus tarsi approach to insert the locking plate for the treatment of calcaneal fractures is safer and more effective,and it is worthy of clinical promotion and application.