改良八字入路钢板内固定对跟骨骨折患者的影响

Effect of Modified Splay Approach Steel Plate Internal Fixation on Patients with Calcaneal Fracture

目的:探讨改良八字入路钢板内固定对跟骨骨折患者的影响。方法:选取2020年3月—2022年6月晋江市医院晋南分院骨科收治的62例跟骨骨折患者。随机将其分为“L”形切口组和改良八字组,各31例。“L”形切口组给予“L”形切口内固定术治疗,改良八字组给予改良八字入路钢板内固定治疗。比较两组围手术期指标,术前和术后6周影像学指标,术后6周足部功能及相关指标,并发症。结果:改良八字组手术时间和下床时间均短于“L”形切口组,术中出血量少于“L”形切口组,差异有统计学意义(P<0.05)。术后6周,两组Bohler角、Gissane角均上升,改良八字组Bohler角、Gissane角均大于“L”形切口组,差异有统计学意义(P<0.05)。改良八字组足部功能改善率高于“L”形切口组,差异有统计学意义(P<0.05)。术后6周,改良八字组骨折愈合评分高于“L”形切口组,骨折愈合时间短于“L”形切口组,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:改良八字入路钢板内固定能够降低患者术中风险,促进患者术后恢复,提高患者治疗效果,改善患者足部功能。

Objective:To explore the effect of modified splay approach steel plate internal fixation on patients with calcaneal fracture.Method:A total of 62 patients with calcaneal fracture admitted to the Department of Orthopedics of Jinnan Branch of Jinjiang City Hospital from March 2020 to June 2022 were selected.They were randomly divided into the"L"incision group and the modified splay group,31 cases in each group.The"L"incision group was treated with"L"incision internal fixation surgery,and the modified splay group was treated with modified splay approach steel plate internal fixation.Perioperative indexes,imaging indexes before and 6 weeks after surgery,foot function and related indexes at 6 weeks after surgery,and complications were compared between the two groups.Result:The operation time and getting out of bed time in the modified splay group were shorter than those in the"L"incision group,and the intraoperative blood loss volume was less than that in the"L"incision group,the differences were statistically significant(P<0.05).At 6 weeks after surgery,Bohler angle and Gissane angle increased in both groups,and Bohler angle and Gissane angle in the modified splayed group were greater than those in the"L"incision group,the differences were statistically significant(P<0.05).The improvement rate of foot function in modified splayed group was higher than that in"L"incision group,and the difference was statistically significant(P<0.05).At 6 weeks after surgery,the fracture healing score of the modified splayed group was higher than that of the"L"incision group,and the fracture healing time was shorter than that of the"L"incision group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Modified splay approach steel plate internal fixation can reduce intraoperative risk of patients,promote postoperative recovery of patients,improve treatment effectiveness,and improve foot function in patients.