Sanders Ⅱ-Ⅲ型跟骨骨折经跗骨窦切口钢板 内固定治疗的临床获益效果评价

Evaluation of the clinical benefit of Sanders Ⅱ-Ⅲ calcaneal fracture treated by tarsal sinus incision plate internal fixation

目的探究Sanders Ⅱ-Ⅲ型跟骨骨折(CF)经跗骨窦切口钢板内固定治疗的临床获益效果。方法选取2022年7月-2023年6月德阳市人民医院骨科108例Sanders Ⅱ-Ⅲ型CF患者,随机分为A组(n=54)与B组(n=54)。B组行外侧L型切口钢板内固定治疗,A组行经跗骨窦切口钢板内固定治疗。比较两组手术相关指标、术前及术后6个月跟骨解剖学指标[跟骨结节关节角(Bohler角)、跟骨交叉角(Gissane角)、跟骨高度、跟骨宽度]、不同时间点(术前、术后1个月、3个月、6个月)美国足踝外科协会(AOFAS)踝与后足评分及治疗后随访6个月内并发症发生情况。结果两组跟骨解剖学指标(术后6个月)均较术前有所改善,且A组手术相关指标、术后不同时间点AOFAS踝与后足功能评分均优于B组,随访6个月内A组并发症发生率为5.56%,低于B组的20.37%,以上差异P均<0.05。结论Sanders Ⅱ-Ⅲ型CF经跗骨窦切口钢板内固定治疗,可缩短手术时长、术后切口长度及住院时长,降低手术失血量,改善术后跟骨解剖学指标,促进跟骨功能恢复,且随访6个月内并发症发生率较低,患者临床获益较高,值得借鉴。

Objective To investigate the clinical benefit of the treatment of Sanders Ⅱ-Ⅲ calcaneal fracture(CF)by plate internal fixation through tarsal sinus incision.Methods 108 patients with Sanders Ⅱ-Ⅲ CF in the Department of Orthopedics of Deyang People’s Hospital from July 2022 to June 2023 were selected and randomly divided into group A(n=54)and group B(n=54).The group B was treated with lateral L-shaped incision plate internal fixation,and the group A was treated with plate internal fixation via tarsal sinus incision.Preoperative and postoperative calcaneal anatomical indexes(Bohler Angle,Gissane Angle,calcaneal height,calcaneal width),ankle and posterior foot scores of American Association of Foot and Ankle Surgery(AOFAS)at different time points(preoperative,postoperative 1 month,3 months,6 months)and postoperative follow-up were compared between the two groups Complications occurred within 6 months of follow-up.Results Anatomic indexes of calcaneus in both groups(6 months after surgery)were improved compared with those before surgery,and operating-related indexes and AOFAS ankle and hind foot function scores at different time points in group A were better than those in group B.The complication rate within 6 months of follow-up was 5.56%in group A lower than 20.37%in group B,and the differences were all P<0.05.Conclusion The treatment of Sanders Ⅱ-Ⅲ CF with tarsal sinus incision and plate internal fixation can shorten the operation time,postoperative incision length and hospital stay,reduce intraoperative blood loss,improve postoperative calcaneal anatomical indexes,and promote the recovery of calcaneal function.In addition,the incidence of complications is lower within 6 months of follow-up,and the clinical benefit of patients is higher,which is worthy of reference.