经跗骨窦小切口空心钉内固定治疗跟骨骨折疗效分析

发布时间：2018-07-05 11:33

本文选题：跟骨骨折 + 跗骨窦入路　；参考：《中国矫形外科杂志》2017年12期

【摘要】：[目的]比较经跗骨窦小切口空心钉内固定与外侧"L"形切口钢板内固定治疗跟骨骨折的临床效果。[方法]选取本院骨科2013年1月~2015年3月收治的跟骨骨折患者150例,根据手术方法不同分为小切口空心钉组和"L"形切口钢板组各75例,小切口空心钉组行经跗骨窦小切口空心钉内固定术,"L"形切口钢板组行外侧"L"形切口钢板内固定术。回顾性分析患者的临床资料,比较两组的手术一般资料、骨折愈合时间、术后并发症、术后即刻影像学参数以及术后1年Maryfand评分情况。[结果]小切口空心钉组手术时间、术中出血量以及术后住院时间均明显低于"L"形切口钢板组,差异有统计学意义(P0.05)。两组患者的骨折愈合时间差异无统计学意义(P0.05)。小切口空心钉组术后并发症发生率为9.3%,"L"形切口钢板组为20.00%,差异有统计学意义(P0.05)。两组术后即刻Bohler角、Gissane角及跟骨中部宽度差异均无统计学意义(P0.05)。术后1年时小切口空心钉组Maryfand评分及优良率均高于"L"形切口钢板组,差异有统计学意义(P0.05)。[结论]与外侧"L"形切口钢板内固定治疗跟骨骨折相比,经跗骨窦小切口空心钉术后恢复效果更佳,且具有微创、手术简便以及周围组织创伤小等优势,符合现代骨科微创治疗的理念。
[Abstract]:[Objective] to compare the clinical effect of internal fixation with small incision of tarsal sinus and internal fixation with lateral "L" shaped incision in the treatment of calcaneal fracture. [Methods] 150 cases of calcaneal fracture treated in the Department of orthopedics, January 2013, ~2015 year, were selected and divided into 75 cases of small incision empty heart nail group and "L" shaped incision plate group according to the different methods of operation. The hollow nail group underwent small incision hollow nail internal fixation through the tarsal sinus and the "L" shaped incision plate group underwent lateral "L" shaped incision plate internal fixation. The clinical data of the patients were analyzed retrospectively. The general data of the two groups, the time of fracture healing, postoperative complications, immediate postoperative imaging parameters and the 1 year Maryfand score after the operation were compared. [results] The operation time of small incision hollow nail group, the amount of bleeding in the operation and the time of postoperative hospitalization were significantly lower than that of the "L" shaped incision plate group, the difference was statistically significant (P0.05). There was no significant difference between the two groups of fracture healing time (P0.05). The incidence of postoperative complications was 9.3% in the small incision hollow nail group and 20% in the "L" shaped incision plate group. There was statistical significance (P0.05). There was no significant difference between the two groups immediately after the operation of Bohler angle, Gissane angle and the width of the middle calcaneus (P0.05). The Maryfand score and the good rate of the small incision hollow nail group at 1 years after the operation were higher than that of the "L" shaped incision plate group, the difference was statistically significant (P0.05). [Conclusion] and the lateral "L" shaped incision plate internal fixation for calcaneus Compared with the small incision of the tarsal sinus, the recovery effect is better, and it has the advantages of minimal invasion, simple operation and small wound around the surrounding tissue, which is in line with the concept of minimally invasive treatment in the modern department of orthopedics.
【作者单位】：苏州市吴江第一人民医院;
【基金】：2010年江苏省自然科学基金资助项目(编号:BK20105)
【分类号】：R687.3

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