骨折撑开器辅助复位技术在跟骨关节内骨折微创内固定手术中的应用价值

Application value of fracture spreader assisted reduction technique in minimally invasive internal fixation for intra-articular calcaneal fracture

目的分析骨折撑开器辅助复位技术在跟骨关节内骨折微创内固定手术中的应用价值。方法以2020年9月至2022年9月收治的90例跟骨关节内骨折患者为研究对象,根据入院先后顺序将其分为对照组(n=45,微创内固定手术)和研究组(n=45,微创内固定手术+骨折撑开器辅助复位技术)。比较两组的治疗效果。结果研究组的手术时间、术中出血量、术后疼痛评分、住院时间、骨折愈合时间、并发症发生率均优于对照组(P<0.05)。研究组的治疗优良率显著高于对照组(P<0.05)。术后1周,研究组的5-羟色胺(5-HT)、P物质(SP)水平低于对照组,免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平高于对照组(P<0.05)。术后3个月,研究组的Bohler角、Gissance角、跟骨长度大于对照组,关节面台阶小于对照组(P<0.05)。结论骨折撑开器辅助复位技术应用于跟骨关节内骨折微创内固定手术治疗中的效果显著,可改善围术期指标,降低对患者机体产生的创伤,利于恢复跟骨解剖形态,值得临床进一步推广应用。

Objective To analyze the application value of fracture spreader assisted reduction technique in minimally invasive internal fixation for intra-articular calcaneal fracture.Methods A total of 90 patients with intra-articular calcaneal fracture admitted from September 2020 to September 2022 were selected as the study objects.A ccording to the order of admission,the patients were divided into control group(n=45,minimally invasive internal fixation)and study group(n=45,minimally invasive internal fixation+fracture spreader assisted reduction technique).The therapeutic effects of the two groups were compared.Results The operative time,intraoperative blood loss,postoperative pain score,hospital stay,fracture healing time and incidence of complications of the study group were better than those of the control group(P<0.05).The excellent and good rate of treatment in the study group was significantly higher than that in the control group(P<0.05).At one week after surgery,the levels of 5-hydroxy tryptamine(5-HT)and substance P(SP)in the study group were lower than those in the control group,while the levels of immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM)were higher than those in the control group(P<0.05).At 3 months after surgery,the Bohler angle,Gissance angle and calcaneal length in the study group were greater than those in the control group,and the articular surface step was smaller than that in the control group(P<0.05).Conclusion The fracture spreader assisted reduction technique applied in minimally invasive internal fixation for intra-articular calcaneal fracture has significant effect.It can improve perioperative indicators,reduce trauma to the patients'body,and facilitate the restoration of calcaneal anatomical morphology,which is worthy of further clinical promotion and application.