关节镜小切口与跗骨窦切口治疗跟骨骨折的疗效比较

Comparison of Arthroscopic Small Incision and Tarsal Sinus Incision in the Treatment of Calcaneal Fractures

目的分析距下关节镜联合后侧小切口与跗骨窦切口在跟骨骨折患者中的应用效果。方法筛选2018年12月至2022年12月聊城市第二人民医院收治的100例跟骨骨折患者,根据随机数表法分为关节镜组和跗骨窦组各50例。关节镜组男32例,女18例,平均年龄(43.58±7.13)岁;给予距下关节镜联合后侧小切口治疗。跗骨窦组男34例,女16例,平均年龄(43.12±7.46)岁;给予跗骨窦切口治疗。对比两组手术相关指标及手术前后疼痛视觉模拟评分(visual analog score,VAS)、B hler角及Gissane角变化,术后12个月踝-后足功能优良率和并发症发生率。结果术后关节镜组随访(11.16±1.02)个月,跗骨窦组随访(11.24±1.06)个月。关节镜组住院时间和骨折愈合时间明显少于跗骨窦组(P<0.05);关节镜组术后12个月VAS评分明显低于跗骨窦组,关节镜组B hler角及Gissane角均明显高于跗骨窦组(P<0.05);相较跗骨窦组,关节镜组优良率更高(P<0.05),并发症发生率更低(P<0.05)。结论相较跗骨窦切口,距下关节镜联合后侧小切口可以明显改善跟骨骨折患者手术指标及疼痛情况,值得临床广泛推广。

Objective To analyze the application of subtalar arthroscopy combined with posterior small incision and tarsal sinus incision in patients with calcaneal fracture.Methods A total of 100 patients with calcaneal fractures admitted to Liaocheng Second People’s Hospital from December 2018 to December 2022 were selected and divided into the arthroscopic group and the tarsal sinus group according to the random number table method.In the arthroscopic group,there were 32 males and 18 females,aged(43.58±7.13)years,all treated with subtalar arthroscopy combined with posterior small incision.In the tarsal sinus group,there were 34 males and 16 females,aged(43.12±7.46)years.The operation-related indicators,changes in visual analog score(VAS),B hler Angle,and Gissane Angle before operation and 12 months after operation,the excellent and good rate of ankle-hindfoot function,and the incidence of complications were compared between the two groups.Results The follow-up time for the arthroscopic group was(11.16±1.02)months,and the follow-up time for the tarsal sinus group was(11.24±1.06)months.The length of hospital stay and fracture healing time in the arthroscopic group were significantly lower than those in the tarsal sinus group(P<0.05).The VAS score of the arthroscopic group was significantly lower than that of the tarsal sinus group at 12 months after operation,and the B hler Angle and Gissane Angle of the arthroscopic group were significantly higher than those of the tarsal sinus group(P<0.05).The excellent and good rate was higher and the complication rate was lower in the arthroscopic group than in the tarsal sinus group(P<0.05).Conclusion Subtalar arthroscopy combined with posterior small incision can significantly improve surgical indicators and reduce pain in patients with calcaneal fractures,which is worthy of clinical promotion.