改良微创切口内固定治疗跟骨骨折的疗效

Clinical effect of modified minimally invasive incision in the treatment of the calcaneal fracture

目的探讨改良微创切口内固定治疗跟骨骨折的临床疗效。方法将23例跟骨骨折患者根据手术切口不同分为传统组(采用传统外侧L形切口内固定治疗,12例)和改良组(采用改良微创切口内固定治疗,11例)。记录两组手术时间、切口总长度、术中出血量及术后切口并发症情况,采用AOFAS踝-后足评分标准评价临床疗效。结果患者均获得随访,时间8~41个月。手术时间、切口总长度、术中出血量改良组均短(少)于传统组(P<0.05)。Böhler角、Gissane角两组术后均较术前增大(P<0.05),两组比较差异均无统计学意义(P>0.05)。传统组出现切口皮缘转角处部分坏死3例,切口裂开1例;改良组1例切口渗出液较多。末次随访时两组AOFAS踝-后足评分优良率比较差异无统计学意义(P>0.05)。结论采用改良微创切口内固定治疗跟骨骨折具有创伤小、切口并发症少、手术时间短等优点,疗效满意。

Objective To investigate the clinical effect of modified minimally invasive incision in the treatment of calcaneal fracture.Methods Twenty-three patients with calcaneal fractures were divided into conventional group(12 cases were treated with conventional lateral L-shaped incision)and modified group(11 cases were treated with modified minimally invasive incision),according to different surgical incisions.The operation time,total incision length,intraoperative blood loss and postoperative incision complications were recorded in the two groups,and the clinical curative effect was evaluated by AOFAS ankle-hindfoot score criterion.Results All patients were followed up for 8~41 months.Operation time,total incision length and intraoperative blood loss in the modified group were all shorter(less)than those in the conventional group(P<0.05).At the postoperation,the Böhler angle and Gissane angle of the two groups were increased than before operation(P<0.05),and there was no significant difference between the two groups(P>0.05).In the conventional group,there were 3 cases of partial necrosis at the corner of incision skin margin and 1 case of incision dehiscence;in the modified group,incision exudation was more in 1 case.There was no significant difference in AOFAS ankle-hindfoot score between the two groups at the last follow-up(P>0.05).Conclusions The modified minimally invasive incision for calcaneal fracture has the advantages of less trauma,few complications of incision,and shorter operation time.