跗骨窦切口微创钢板内固定与螺钉内固定治疗跟骨关节内骨折的疗效分析

Therapeutic Effect of Minimally Invasive Plate Internal Fixation and Screw Internal Fixation with Tarsal Sinus Incision on Calcaneal Intraar⁃ticular Fracture

目的 分析跗骨窦切口微创钢板内固定与螺钉内固定治疗跟骨关节内骨折的疗效。方法 随机选取2018年1月—2021年12月期间厦门市第三医院收治的40例跟骨关节内骨折患者为研究对象,依据患者的内固定方式将其分为研究组和参考组,各20例。两组患者均接受跗骨窦切口微创内固定治疗,参考组患者采用微创钢板内固定治疗,研究组患者采用螺钉内固定治疗。比较两组手术前后跟骨Gissane角和Bohler角改善情况、手术前后生活质量评分情况、平均手术时间、住院时间、疼痛评分、并发症发生率、平均住院费用、植入物取出率。结果 研究组跟骨Gissane角和Bohler角改善情况、手术前后生活质量评分、平均手术时间、住院时间、疼痛评分、并发症发生率与参考组比较,差异无统计学意义(P>0.05)。而研究组平均住院费用为(2 140.52±180.13)元,明显低于参考组的(4 452.80±220.18)元,差异有统计学意义(t=36.351,P<0.05)。研究组植入物取出率为25.00%,明显低于参考组的80.00%,差异有统计学意义(χ^(2)=12.130,P<0.05)。结论 跗骨窦切口微创钢板内固定与螺钉内固定治疗期间的临床疗效相比无显著差异,而采用螺钉内固定治疗更能降低手术费用和植入物取出率。

Objective To analyze the therapeutic effect of minimally invasive plate internal fixation and screw internal fixation with tarsal sinus incision on calcaneal intraarticular fracture.Methods 40 patients with intra-articular calca⁃neal fractures admitted to Xiamen Third Hospital from January 2018 to December 2021 were randomly selected as the study subjects,and divided into the study group and the reference group according to the internal fixation method of the patients,with 20 cases in each.Both groups received minimally invasive internal fixation with tarsal sinus inci⁃sion.The reference group received minimally invasive plate internal fixation,and the study group received screw inter⁃nal fixation.The improvement of Gissane angle and Bohler angle of the calcaneus before and after operation,quality of life score before and after operation,average operation time,hospital stay,pain score,incidence of complications,aver⁃age hospitalization cost and implant removal rate were compared between the two groups.Results There was no statis⁃tically significant difference between the study group and the reference group in the improvement of Gissane angle and Bohler angle of the calcaneus,quality of life score before and after operation,average operation time,hospitaliza⁃tion time,pain score,and incidence of complications(P>0.05).The average hospitalization cost in the study group was(2140.52±180.13)yuan,which was significantly lower than that in the reference group(4452.80±220.18)yuan,the difference was statistically significant(t=36.351,P<0.05).The removal rate of implants in the study group was 25.00%,significantly lower than 80.00%in the reference group,and the difference was statistically significant(χ^(2)=12.130,P<0.05).Conclusion There was no significant difference in clinical efficacy between minimally invasive plate internal fixation for tarsal sinus incision and screw internal fixation during treatment,while screw internal fixation was more effective in reducing surgical costs and the removal rate of implants.