跗骨窦切口全螺纹无头加压中空螺钉内固定治疗跟骨骨折

目的观察跗骨窦切口全螺纹无头加压中空螺钉内固定治疗跟骨骨折的临床疗效。方法分析自2018年6月至2021年12月诊治的46例SandersⅡ、Ⅲ型跟骨骨折患者,23例经跗骨窦切口采用全螺纹无头加压中空螺钉内固定(观察组),23例经常规跟骨外侧L形切口采用锁定钢板内固定(对照组)。比较两组患者术中及术后随访资料。结果46例均获得了完整随访,随访时间平均16.5(6~24)个月。跗骨窦切口组手术时间、下地完全负重时间短于常规切口组(P<0.05),两组术后6个月AO-FAS评分差异无统计学意义(P>0.05)。两组术后12周Bohler角和Gissane角均较术前显著增加(P<0.05),术后12周两组间Bohler角和Gissane角的差异无统计学意义(P>0.05)。结论跗骨窦切口全螺纹无头加压中空螺钉内固定治疗跟骨骨折能够缩短手术时间、提前负重,固定牢固可靠,可有效恢复跟骨正常解剖形态,较好的恢复足踝功能。

Objective To observe the clinical effect of the treatment of calcaneal fracture with full-thread and headless compression hollow screw internal fixation in the incision of tarsal sinus.Methods From June 2018 to December 2021,46 patients with Sanders typeⅡandⅢcalcaneal fractures were treated and analyzed.23 patients were treated with full-thread headless compression hollow screw internal fixation via tarsal sinus incision(the observation group),and 23 patients were treated with locking plate internal fixation via conventional L-shaped incision of lateral calcaneal(the control group).The intraoperative and postoperative follow-up data of the two groups were compared.Results All 46 patients were followed up for an average of 16.5(6~24)months.The operation time and total weight-bearing time of the tarsal sinus incision group were shorter than those of the conventional incision group,with statistical significance(P<0.05),and there was no significant difference in AO-Fas score between the two groups 6 months after surgery(P>0.05).Bohler Angle and Gissane Angle were significantly increased in both groups 12 weeks after surgery(P<0.05),but there was no significant difference in Bohler Angle and Gissane Angle between the two groups 12 weeks after surgery(P>0.05).Conclusion The treatment of calcaneus fracture with full-thread headless compression hollow screw internal fixation through the incision of the tarsal sinus can shorten the operation time and advance weight bearing.The fixation is firm and reliable,and the normal anatomical morphology of calcaneus can be effectively restored,and the foot and ankle function can be better restored.