跗骨窦切口微型钢板联合空心钉内固定治疗跟骨骨折的疗效

Sinus tarsal incision mini-plate combined with cannulated nail internal fixation for calcaneal fracture

目的 探讨予跟骨骨折患者跗骨窦切口并配合使用微型钢板、空心钉内固定的效果。方法 选择灌云县人民医院骨科2016年6月至2022年6月收治的跟骨骨折患者57例进行前瞻性研究,以抛币法分为两组,对照组(n=28)采用常规L形切口普通钢板内固定治疗,观察组(n=29)采用跗骨窦切口微型钢板联合空心钉内固定治疗,比较两组手术及恢复指标,采用美国足踝外科协会(American Orthopaedic and Ankle Society,AOFAS)踝-后足评分评估两组后足功能优良率,并比较末次随访时解剖结构,另比较两组并发症情况。结果 观察组手术时间、消肿时间较对照组短,出血量、切口长度较对照组小(P <0.05),两组骨折愈合时间、后足功能优良率以及术后跟骨宽度、高度、轴长、Bohler角、Gissane角比较,差异均无统计学意义(P> 0.05)。观察组并发症总发生率低于对照组(P <0.05)。结论 跟骨骨折患者采用跗骨窦切口微型钢板与空心钉治疗,操作简单且对患者损伤小,有利于其术后康复,足部功能及解剖恢复良好,并发症风险低。

Objective To investigate the effect of tarsal sinus incision microplate combined with hollow nail internal fixation on patients with calcaneal fracture.Methods 57 patients with calcaneal fracture admitted from June 2016 to June 2022 were prospectively studied and divided into two groups by coin toss method.The control group(n=28)was treated with conventional L-shaped incision common plate internal fixation,and the observation group(n=29)was treated with tarsal sinus incision miniature plate combined with hollow nail internal fixation.The AOFAS score was used to evaluate the hind foot function of the two groups,and the anatomical structure was compared before and at the last follow-up,and the complications of calcaneal fracture were evaluated in both groups.Results The operation time,blood loss,incision length and detumescence time of the observation group these indexes were more ideal after internal fixation of tarsal sinus incision with micromaterials(P<0.05),and there were no significant differences in fracture healing time,excellent and good rate of hind foot function,calcaneal width,height,axial length,Bohler angle and Gissane angle between the two groups(P>0.05).The risk of complications was lower in the observation group after minimally invasive incision combined with micro-plate and hollow nail treatment(P<0.05).Conclusion The treatment of calcaneal fracture with tarsal sinus incision miniature plate is simple and has little damage to patients,which is conducive to postoperative rehabilitation,good recovery of foot function and anatomy,and low risk of complications,so it is worth promoting.