“八”字切口入路治疗跟骨骨折的疗效评价

Evaluation of the efficacy of“eight-shape”incision approach in the treatment of calcaneal fractures

目的比较“八”字切口入路与“L”形切口入路治疗跟骨骨折的疗效差异。方法选取2018年1月至2021年12月行内固定治疗的跟骨骨折患者为研究对象,其中行“八”字切口入路患者88例、93足纳入研究组,行“L”形切口入路患者82例、85足纳入对照组,比较两组术中出血量、手术时间、住院时间、术后踝-后足功能指标差异和术后12个月随访期内的并发症差异,并采用Kaplan-Meier生存分析法比较12个月内首发并发症的时间差异。结果两组手术时间、术中出血量和住院时间比较,差异均无统计学意义(P>0.05);术后1个月各项踝-后足功能指标比较,差异也无统计学意义(P>0.05);但研究组切口红肿与浅表皮缘坏死的发生率低于对照组,差异有统计学意义(P<0.05);Kaplan-Meier生存分析显示,术后12个月研究组的首发并发症时间晚于对照组,差异有统计学意义(P<0.05)。结论“八”字切口入路治疗跟骨骨折的手术疗效与传统“L”形切口入路方式相当,但并发症的发生率低于传统“L”形切口入路,并且更为微创、美观,值得推广使用。

Objective To compare the therapeutic effects of“eight-shape”incision approach and“L-shape”incision approach in the treatment of calcaneal fractures.Methods Patients with calcaneal fractures who underwent internal fixation from January 2018 to December 2021 were selected as the research objects.Among them,88 patients(93 feet)who underwent“eight-shape”incision approach were included in the study group,and 82 patients(85 feet)who underwent“L-shape”incision approach were included in the control group.The intraoperative bleeding,operative time,hospitalization time,and postoperative heel-ankle function indexes and complications during the 12-month follow-up were compared between the two groups.Kaplan-Meier survival analysis was used to compare the time of the first occurrence of complication within 12 months.Results There was no statistically significant difference in the operation time,intraoperative bleeding and hospitalization time between the two groups(P>0.05),and there was no significant difference in heel-ankle function indexes at one month after operation(P>0.05).However,the incidence of incisional swelling and superficial epidermal marginal necrosis in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Kaplan-Meier survival analysis showed that the time of the first occurrence of complication in the study group was later than that in the control group within 12 months after surgery,and the difference was statistically significant(P<0.05).Conclusion The surgical efficacy of the“eight-shape”incision approach in the treatment of calcaneal fractures is comparable to that of the traditional“L-shape”incision approach,but the incidence of complications is lower than that of the traditional“L-shape”incision approach,and is more minimally invasive and aesthetically pleasing,which is worthy of popularization..