跗骨窦切口治疗跟骨关节内骨折的临床疗效

Clinical effect of tarsal sinus incision in the treatment of intra-articular calcaneal fractures

目的 探讨跗骨窦切口治疗跟骨关节内骨折患者的临床疗效。方法 选取2017年9月至2020年9月本院收治的30例跟骨关节内骨折患者作为研究对象,按照随机数字表法分为常规组(传统外侧L型切口治疗)与研究组(跗骨窦切口治疗),各15例。比较两组手术治疗优良率、手术时间、骨折愈合时间、切口大小、手术失血量、术后24 h疼痛评分、并发症发生情况、Gissane角、Bohler角以及Maryland评分、Kofoed评分。结果 研究组手术治疗优良率为93.33%,略高于常规组的80.00%,但组间比较差异无统计学意义;研究组手术时间、骨折愈合时间均短于常规组,切口大小小于常规组,手术失血量少于常规组,术后24 h疼痛评分及并发症发生率均低于常规组(P<0.05);术后12个月,两组影像学技术评价Gissane角、Bohler角及Maryland评分、Kofoed评分均高于术前(P<0.05),但两组比较差异无统计学意义。结论 跗骨窦切口与传统外侧L型切口治疗跟骨关节内骨折患者均具有一定疗效,但前者具有疼痛轻、微创、术后并发症少、骨折愈合速度快等优势,值得临床推广应用。

Objective To investigate the clinical effect of incision treatment of tarsal sinus in patients with intra-articular calcaneal fractures.Methods A total of 30 patients with intra-articular calcaneal fractures admitted to our hospital from September 2017 to September 2020 were selected as the study subjects, and they were divided into the conventional group(traditional lateral L-shaped incision treatment) and the study group(tarsal sinus incision treatment) according to the random number table method, with 15 cases in each group. The excellent and good rate of surgical treatment,operative time, fracture healing time, incision size, operative blood loss, 24 h postoperative pain score, the incidence of complications, Gissane angle,Bohler angle, Maryland score and Kofoed score were compared between the two groups. Results The excellent and good rate of surgical treatment in the study group was 93.33%, slightly higher than the 80.00% in the routine group, but there was no significant difference between the groups. The operative time and fracture healing time of the study group were shorter than that of the conventional group, the incision size was smaller than that of the conventional group, the operative blood loss was less than that of the conventional group, 24 h postoperative pain score and the total incidence of complications were lower than those of the conventional group(P<0.05). 12 months after surgery, imaging evaluation of Gissane Angle, Bohler Angle,Maryland score and Kofoed score in two groups were higher than those before surgery(P<0.05), and there was no significant difference between the two groups. Conclusion Both the tarsal sinus incision and the traditional lateral L-shaped incision have certain efficacy in the treatment of intra-articular calcaneal fractures, but the former has the advantages of light pain, minimally invasive, fewer postoperative complications and fast fracture healing, which is worthy of clinical application.