Application of special plate internal fixation for tarsal sinus in the treatment of collapsed posterior articular surface fractures of calcaneus
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摘要: 目的 探讨跗骨窦专用钢板在跟骨后关节面塌陷型骨折中的应用效果。 方法 选取45例(患足56足)跟骨后关节面塌陷型骨折患者作为研究对象,按随机数表法将其分为观察组23例(患足30足)和对照组22例(患足26足)。对照组采用传统外侧“L”形切口内固定治疗,观察组采用跗骨窦专用钢板内固定治疗。观察并比较2组患者手术时间、住院时间、术中透视次数、术中出血量; 术后随访3个月,采用Maryland足功能评分标准、美国足踝外科学会(AOFAS)后足评分系统评价2组术后足功能恢复情况,并比较2组术后并发症发生情况。 结果 观察组手术时间、住院时间短于对照组,术中透视次数、术中出血量少于对照组,差异有统计学意义(P<0.05)。术后, 2组Bohler角、Gissane角均显著优于术前(P<0.05), 但2组间差异无统计学意义(P>0.05)。观察组患足功能恢复优良率显著高于对照组(P<0.05); 观察组术后并发症发生率显著低于对照组(P<0.05)。 结论 经跗骨窦入路微创小切口切开复位钢板内固定术治疗跟骨后关节面塌陷型骨折疗效显著,复位效果优良,可减少术中出血量,缩短患者住院时间,降低术后并发症发生率。Abstract: Objective To explore the effect of special plate for tarsal sinus in the treatment of collapsed posterior articular surface fractures of calcaneus. Methods A total of 45 patients(56 feet)with collapsed posterior articular surface fractures of calcaneus who were admitted to our hospital were selected as research objects, and were divided into observation group(23 cases and 30 feet )and control group(22 cases and 26 feet )according to random number table method. The patients in the control group underwent traditional lateral L-shaped incision internal fixation, and the observation group was given a special steel plate in tarsal sinus surgery. The operative time, hospital stay, intraoperative fluoroscopy times and intraoperative blood loss were observed and compared between the two groups. After 3 months of follow-up, the functional recovery conditions of postoperative foot function were compared between the two groups by Maryland Foot Function Scoring and foot scoring of American Orthopedic Foot Andankle Society(AOFAS). The occurrence of postoperative complications was compared between the two groups. Results The operation time and hospitalization day in the observation group were shorter, intraoperative fluoroscopy times and intraoperative blood loss of the observation group were less than those of control group(P<0.05). The Bohler angle and Gissane angle in the two groups were better than those before operation(P<0.05), but no significant differences were found(P>0.05). The excellent and good rate of recovery in foot function in the observation group was significantly higher than that in the control group(P<0.05). The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05). Conclusion The minimally invasive small incision through the tarsal sinus approach with open reduction and - internal fixation in the treatment of collapsed fractures of the posterior articular surface of the calcaneus has significant efficacy, and better reduction efficacy. Besides, it can reduce intraoperative blood loss, shorten the length of hospital stay and reduce the incidence of postoperative complications.
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Keywords:
- calcaneus /
- fracture /
- tarsal sinus approach /
- steel plate /
- internal fixation /
- Kirschner nail /
- complication
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吕小飞, 胡振春. 经跗骨窦微创小切口入路行钢板内固定术治疗跟骨骨折的临床效果观察[J]. 实用临床医药杂志, 2019, 23(16): 82-85. 胡绿洲, 潘立群, 周建双. 经跗骨窦小切口空心钉内固定术治疗跟骨骨折近期疗效分析[J]. 浙江临床医学, 2020, 22(1): 70-72. 徐向阳, 胡牧. 跟骨骨折的治疗现状与微创趋势[J]. 中国骨伤, 2019, 32(11): 979-981. FAROUK A, IBRAHIM A, ABD-ELLA M M, et al. Effect of subtalar Fusi onand calcaneal osteotomy on function, pain, and gait mechanics for calcaneal malunion[J]. Foot Ankle Int, 2019, 40(9): 1094-1103.
JORDAN M C, FUCHS K, HEINTEL T M, et al. Are variable-angle locking screws stable enough to prevent calcaneal articular surface collapse: A biomechanical study[J]. J Orthop Trauma, 2018, 32(6): e204-e209.
詹俊锋, 方家刘, 荆珏华, 等. 外侧横切口双窗入路钢板固定治疗跟骨关节内骨折[J]. 中华创伤骨科杂志, 2019, 21(12): 1085-1089. 朱国伍. 经跗骨窦入路和经外侧入路手术治疗跟骨骨折的临床疗效分析[J]. 山西医药杂志, 2020, 49(3): 303-304. KITAOKA H B, ALEXANDER I J, ADELAAR R S, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes[J]. Foot Ankle Int, 1997, 18(3): 187-188.
KIEWIET N J, SANGEORZAN B J. Calcaneal fracture management[J]. Foot Ankle Clin, 2017, 22(1): 77-91.
RAUER T, TWERENBOLD R, FLÜCKIGER R, et al. Avulsion fracture of the calcaneal tuberosity: case report and literature review[J]. J Foot Ankle Surg, 2018, 57(1): 191-195.
廉养杰. 跗骨窦切口空心螺钉内固定治疗对SandersⅢ型跟骨骨折患者Bohler角、Gissane角、跟骨高度与宽度的影响[J]. 实用临床医药杂志, 2019, 23(2): 14-17. 王一飞, 薛锋. 跗骨窦入路微型钢板治疗跟骨骨折的疗效[J]. 临床骨科杂志, 2020, 23(1): 138-141. ZHANG G M, DING S L, RUAN Z Y. Minimally invasive treatment of calcaneal fracture[J]. J Int Med Res, 2019, 47(8): 3946-3954.
赵航, 陈戈, 毕鑫, 等. 三种手术方法治疗Sanders Ⅲ 型跟骨骨折的疗效比较[J]. 中国骨与关节杂志, 2020, 9(3): 186-193. 荣向科, 朱修文, 刘刚义, 等. 急诊手术治疗跟骨关节内移位骨折的疗效观察[J]. 中国骨与关节损伤杂志, 2019, 34(12): 1333-1335. 简蔚泓, 丁健, 沈峰. 经跗骨窦切口内固定术与经外侧“L”形切开钢板内固定术治疗SandersⅡ~Ⅲ型跟骨骨折的效果比较[J]. 实用临床医药杂志, 2019, 23(19): 83-85 , 89.
曾勇, 唐弢, 文超. 跗骨窦入路结合微型锁定板治疗SandersⅡ、Ⅲ型跟骨骨折[J]. 四川医学, 2019, 40(11): 1146-1149. 陈海宁, 崔学文, 江红卫, 等. 经跗骨窦小切口在跟骨骨折手术中的应用[J]. 创伤外科杂志, 2019, 21(11): 842-846.
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