经皮撬拨复位空心钉内固定术对SandersⅡ、Ⅲ型跟骨骨折足踝功能的影响

The effect of percutaneous prying reduction and hollow nail internal fixation on foot and ankle function in Sanders typeⅡandⅢcalcaneal fractures

目的探讨经皮撬拨复位空心钉内固定术对SandersⅡ、Ⅲ型跟骨骨折足踝功能的影响。方法选择长沙医学院附属澧县人民医院2020年4月-2023年4月收治的SandersⅡ、Ⅲ型跟骨骨折97例,按随机数字表法分为对照组48例与观察组49例。对照组行切开复位内固定术,观察组行经皮撬拨复位空心钉内固定术。比较两组围术期指标、影像学指标、足踝功能及术后并发症。结果观察组手术及住院时间短于对照组,术中出血量及术后24 h引流量少于对照组,差异有统计学意义(P<0.05);术后观察组跟骨宽度、跟骨高度、Bohler角、Gissane角与对照组比较,差异无统计学意义(P>0.05);观察组Maryland足功能评分的各维度分值均高于对照组,并发症率低于对照组,差异有统计学意义(P<0.05)。结论采取经皮撬拨复位空心钉内固定术治疗SandersⅡ、Ⅲ型跟骨骨折更具微创优势,可有效促进足踝功能恢复,降低术后并发症率。

Objective To explore the effect of percutaneous prying reduction and hollow nail internal fixation on Sanders typeⅡandⅢcalcaneal fractures.Methods Ninety-seven cases of SandersⅡandⅢcalcaneal fractures were selected from Lixian People's Hospital affiliated to Changsha Medical University from April 2020 to April 2023.They were randomly divided into the control group(48 cases)and the observation group(49 cases).The control group underwent open reduction and internal fixation,while the observation group underwent percutaneous prying reduction and hollow nail internal fixation.Compared the perioperative indicators,imaging indicators,ankle function,and postoperative complications between two groups.Results Showed that the observation group had shorter surgical and hospitalization times than the control group,and the intraoperative bleeding volume and postoperative drainage volume at 24 hours were lower than the control group,with statistically significant differences(P<0.05);After surgery,there was no statistically significant difference in the width,height,Bohler angle,and Gissane angle between the observation group and the control group(P>0.05);The observation group had higher scores in all dimensions of Maryland's foot function score than the control group,and the postoperative complication rate was lower than the control group,with a statistically significant difference(P<0.05).Conclusion Percutaneous prying reduction and hollow nail internal fixation is more minimally invasive in the treatment of Sanders typeⅡand III calcaneal fractures,which can effectively promote the recovery of foot and ankle function and reduce the incidence of postoperative complications.