经跗骨窦入路治疗SandersⅡ、Ⅲ型跟骨骨折25例

25 Cases Clinical Study on Tarsal Sinus Approach on the Treatment of Comminuted Sanders Ⅱ、Ⅲ Type Calcaneus Fracture

目的:观察经跗骨窦入路的手术方法在治疗SandersⅡ、Ⅲ型跟骨骨折中的疗效。方法:通过回顾性研究的方法,系统性分析25例(27足)经跗骨窦入路微创手术治疗跟骨骨折的患者资料。分析患者的术前一般资料,统计患者术后并发症的发生情况,比较患者术前术后的跟骨B9hler角、Gissane角、跟骨宽度及高度的变化,记录末次随访时的AOFAS踝-后足评分。结果:纳入病例获得完整随访,平均随访时间为(16.21±4.25)个月。根据Sanders分型:Ⅱ型15足,Ⅲ型12足。术后无骨折不愈合、切口感染、骨髓炎等并发症。患者术后的跟骨B9hler角、Gissane角、跟骨宽度及高度均较术前有明显的改善,差异有统计学意义(P<0.05)。根据AOFAS踝-后足评分标准,患者术后疗效:优19足,良6足,可2足,优良率为92.6%(25/27)。结论:经跗骨窦入路微创手术治疗SandersⅡ、Ⅱ型跟骨骨折短期内可取得满意的疗效。

Objective:To evaluate the therapeutic efficacy of transtarsal sinus approach on the treatment of comminuted calcaneal fracture.Methods:The data of 25 patients(27 feet) with calcaneal fracture treated by minimally invasive surgery via tarsal sinus approach were systematically analyzed retrospectively.The preoperative data of the patients were collected.The incidence of postoperative complications was assessed.The changes of calcaneal B9 hler angle, Gissane angle, calcaneal width and height were compared before and after surgery, and the AOFAS ankle-hind foot score was recorded at the last follow-up.Results:The included patients were followed up for an average of(16.21±4.25) months.According to Sanders fracture classification, 15 feet were type Ⅱ fracture and 12 feet were type Ⅲ fracture.No postoperative complications such as fracture nonunion, incision infection and osteomyelitis occurred.The B9 hler angle, Gissane angle, and calcaneal width and height were significantly improved after surgery(P<0.05).According to AOFAS ankle-hind foot scoring criteria, the postoperative efficacy was excellent in 19 feet, good in 6 feet and fair in 2 feet, with an excellent/good rate of 92.6%(25/27).Conclusion:Minimally invasive surgery via the tarsal sinus approach for comminuted calcaneal fractures has satisfactory results in the short term.