微创空心螺钉与解剖钢板内固定治疗SanderⅡ、Ⅲ型跟骨骨折的效果

Effect of Minimally Invasive Hollow Screw and Anatomical Plate Internal Fixation in the Treatment of SanderⅡandⅢCalcaneal Fractures

目的:研究微创空心螺钉与解剖钢板内固定治疗SanderⅡ、Ⅲ型跟骨骨折的临床效果。方法:选取2016年6月-2021年5月广东省水电医院收治的80例跟骨骨折患者作为研究对象。按随机数字表法将其分为微创组和解剖组,各40例。解剖组给予切开复位解剖钢板内固定治疗,微创组给予微创空心螺钉治疗。比较两组围手术期指标、解剖学指标、疼痛情况和足部功能及并发症。结果:微创组手术时间、住院时间短于解剖组,出血量少于解剖组,完全负重时间早于解剖组(P<0.05)。术后3个月,两组B;hler角、Gissane角及跟骨宽度比较差异均无统计学意义(P>0.05)。术后3个月,微创组视觉模拟评分法(VAS)评分低于解剖组(P<0.05),美国足踝外科协会(AOFAS)评分高于解剖组(P<0.05)。微创组并发症发生率仅为7.5%,明显低于解剖组的25.0%(P<0.05)。结论:微创空心螺钉和解剖钢板内固定治疗SanderⅡ、Ⅲ型跟骨骨折均有较好效果,但微创空心螺钉治疗操作更便捷,手术时间更短,出血量更少,明显缩短患者住院时间和负重时间,缓解疼痛,术后并发症更少,值得临床应用及推广。

Objective:To study the clinical effect of minimally invasive hollow screw and anatomical plate internal fixation in the treatment of SanderⅡandⅢcalcaneal fractures.Method:A total of 80 patients with calcaneal fracture admitted to Guangdong Hydropower Hospital from June 2016 to May 2021 were selected as the research objects.They were divided into minimally invasive group and anatomical group according to the random number table method,with 40 cases in each group.The anatomical group was given the open reduction anatomical plate internal fixation treatment,and the minimally invasive group was given the minimally invasive hollow screw treatment.The perioperative indexes,anatomical indexes,pain condition,foot function and complications were compared between the two groups.Result:The operation time and hospital stay in the minimally invasive group were shorter than those in the anatomical group,the amount of bleeding was less than that in the anatomical group,and the complete weight-bearing time was earlier than that in the anatomical group(P<0.05).Three months after operation,there was no significant difference in B?hler angle,Gissane angle and calcaneal width between the two groups(P>0.05).Three months after operation,the visual analogue scale(VAS)score was lower(P<0.05),and American Orthopaedic Foot and Ankle Society(AOFAS)score in the minimally invasive group was higher than that in the anatomical group(P<0.05).The incidence of complications in the minimally invasive group was only 7.5%,which was significantly lower than 25.0%in the anatomical group(P<0.05).Conclusion:Minimally invasive hollow screw and anatomical plate internal fixation have good effects in the treatment of SanderⅡandⅢcalcaneal fractures,but the minimally invasive hollow screw treatment is more convenient,the operation time is shorter,the amount of bleeding is less,the hospital time and weight-bearing time of patients are significantly shortened,the pain is relieved,and the postoperative complications are less,which is worthy of clinical application and promotion.