撬拨复位微创置板内固定术治疗SandersⅡ/Ⅲ型跟骨骨折的疗效

Evaluation on the effect of poking reduction and minimally invasive plate placement combined with internal fixation in patients with Sanders classification II-III calcaneal fractures

目的探讨撬拨复位微创置板内固定术治疗SandersⅡ/Ⅲ型跟骨骨折的疗效。方法选择浙江新安国际医院2017年5月1日-2021年5月1日接受治疗的SandersⅡ/Ⅲ型跟骨骨折患者80例,按数字表法随机分为对照组和撬拨复位组,每组40例。对照组采用改良经跗骨窦小切口空心钉内固定术治疗,撬拨复位组采用撬拨复位微创置板内固定术治疗。比较两组手术前后踝-后足评分量表(AOFAS)、Bohler角、Gissane角、跟骨宽度以及术后并发症。结果术后1周、术后6个月,两组AOFAS评分比较,撬拨复位组更高(P<0.05);术后1天、术后6个月,两组Bohler角、Gissane角撬拨复位组更高;跟骨宽度撬拨复位组更低;两组术后切口感染、皮缘坏死、腓肠神经损伤、钉道感染发生率对比,撬拨复位组更低;以上差异均有统计学意义(P<0.05或P<0.01)。结论撬拨复位微创置板内固定术治疗SandersⅡ/Ⅲ型跟骨骨折足部功能明显改善,术后并发症少。

Objective To analyze the clinical effect of poking reduction and minimally invasive plate placement combined with internal fixation for the treatment of patients with Sanders classificationⅡ/Ⅲcalcaneal fractures.Methods Eighty patients with Sanders classificationⅡ/Ⅲcalcaneal fractures who treated in our hospital from May 1,2017 to May 1,2021 were selected and randomly divided into the control group and the observation group,with 40 cases in each group.The patients in the control group received the modified transtarsal small incision cannulated screw internal fixation,and the patients in the observation group received poking reduction and minimally invasive plate placement combined with internal fixation.The preoperative and postoperative American orthopedic foot and ankle society(AOFAS),Bohler angle,Gissane angle,calcaneal width,and postoperative complications were compared before and after surgery.Results At 1 week and 6 months after surgery,the AOFAS scores in the observation group was higher than that in the control group(P<0.05).At 1 day and 6 months after surgery,the Bohler angle and Gissane angle in the observation group were higher than those in the control group(P<0.05).The calcaneal width in the observation group was lower than that in the control group(P<0.05);the incidence of postoperative incision infection,skin margin necrosis,sural nerve injury,and pin-site infection in the observation group was lower than than that in the control group(P<0.05).Conclusions Poking reduction and minimally invasive plate placement combined with internal fixation for the treatment of Sanders classificationⅡ/Ⅲcalcaneal fractures can significantly improve the foot function,and can reduce postoperative complications.