经皮撬拨闭合复位空心钉与切开复位钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折疗效比较

Comparison of the curative effect of percutaneous prying and closed reduction with hollow nail fixation open reduction and steel plate internal fixation in the treatment of sonders typeⅡ、Ⅲcalcaneal fractures

目的探讨经皮撬拨闭合复位空心钉内固定与切开复位钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折的临床疗效。方法选取2019年1月-2022年3月于济宁市第二人民医院手足外科治疗的SandersⅡ、Ⅲ型跟骨骨折患者102例作为研究对象,根据随机数字表法将其分为对照组和观察组,各51例。对照组实施切开复位钢板内固定治疗,观察组实施经皮撬拨闭合复位空心钉内固定治疗。对比两组术中出血量、手术时间、住院时间,术前与术后3个月的Gissane角、Bohler角、跟骨高度、跟骨宽度以及Maryland足功能评分,并发症发生情况。结果观察组术中出血量、手术时间、住院时间均少于对照组(P<0.05);两组术后3个月的Gissane角、Bohler角、跟骨高度均高于术前(P<0.05),跟骨宽度均低于术前(P<0.05),观察组Maryland足功能评分高于对照组(P<0.05);观察组切口感染、皮缘坏死、足跟痛以及创伤性关节炎并发症发生率低于对照组(P<0.05)。结论SandersⅡ、Ⅲ型跟骨骨折实施经皮撬拨闭合复位空心钉内固定治疗可提高疗效,促进跟骨骨折的康复,改善足功能以及减少并发症的发生。

Objective To explore the efficacy of percutaneous prying,closed reduction,hollow nail internal fixation,and open reduction,steel plate internal fixation in the treatment of Sanders type II and III calcaneal fractures.Methods One hundred and two Sanders II and III type calcaneal fractures'patients who were treated in the Hand and Foot Surgery Department of the Second People's Hospital of Jining City from January 2019 to March 2022 were selected as the study subjects.They were divided into a control group and an observation group using a random number table method,with 51 cases in each group.The control group received open reduction and internal fixation with steel plates,while the observation group received percutaneous prying,closed reduction,and internal fixation with hollow screws.Compared the intraoperative bleeding volume,surgical time,hospital stay,Gissane angle,Bohler angle,calcaneal height,calcaneal width,and Maryland foot function score before and 3 months after surgery between two groups,as well as the incidence of complications.Results The intraoperative bleeding volume,surgical time,and hospital stay in the observation group were all lower than those in the control group(P<0.05);The Gissane angle,Bohler angle,calcaneal height,and calcaneal width the two groups of patients 3 months after surgery were all higher than before surgery(P<0.05).The calcaneal width of two groups of patients 3 months after surgery was lower than before surgery(P<0.05).The Maryland foot function score of the observation group 3 months after surgery was higher than that of the control group(P<0.05);The incidence of incision infection,skin necrosis,heel pain,and complications of traumatic arthritis in the observation group was lower than that in the control group(P<0.05).Conclusion Percutaneous prying,closed reduction,and hollow nail internal fixation can improve surgical outcomes,promote the recovery of calcaneal fracture diseases,improve patient foot function,and reduce the occurrence of complications in Sanders II and III type calcaneal fractures.