改良跗骨窦切口和扩大跟骨外侧L形切口钢板固定治疗SanderⅡ~Ⅲ型跟骨骨折术后疗效和并发症比较

谢振宇; 尹成; 董玉银; 牛安全; 郭坤; 张文龙; 吴狄

doi:10.13898/j.cnki.issn.1000-2200.2023.09.016

改良跗骨窦切口和扩大跟骨外侧L形切口钢板固定治疗SanderⅡ~Ⅲ型跟骨骨折术后疗效和并发症比较

Comparison of postoperative efficacy and complications between modified tarsal sinus incision and expanded lateral calcaneal L-shaped incision plate fixation for Sander Ⅱ-Ⅲ calcaneal fractures

摘要

摘要:
目的比较改良跗骨窦切口和扩大跟骨外侧L形切口钢板固定治疗SanderⅡ~Ⅲ型跟骨骨折术后疗效和并发症发生情况。
方法选取80例SanderⅡ~Ⅲ型跟骨骨折病人，随机分为跗骨窦切口组和L形切口组，各40例，分别行改良跗骨窦切口、扩大跟骨外侧L形切口钢板固定治疗。比较2组手术情况、恢复情况、术后并发症发生情况及术后12个月足踝关节功能变化。
结果跗骨窦切口组手术时间、术中出血量、术后住院时间均明显低于L形切口组(P < 0.01)，2组骨折愈合时间差异无统计学意义(P>0.05)。跗骨窦切口组术后并发症发生率为5.00%(2/40)，低于L形切口组的22.50%(9/40)(P < 0.05)。2组术后1年Bohler角、Gissane角、跟骨中部宽度、Mayfand评分均高于术前(P < 0.05)；跗骨窦切口组术后1年Mayfand评分明显高于L形切口组(P < 0.01)。跗骨窦切口组术后1年临床优良率为77.50%(31/40)，高于L形切口组的60.00%(24/40)(P < 0.05)。
结论改良跗骨窦切口治疗Sander SanderⅡ~Ⅲ型跟骨骨折的疗效优于扩大跟骨外侧L形切口钢板固定，且前者术后恢复更快、并发症发生率更低、足部功能恢复更理想。

Abstract:
ObjectiveTo compare the efficacy and complications of modified tarsal sinus incision and expanded lateral calcaneal L-shaped incision plate fixation for SanderⅡ-Ⅲ calcaneal fractures.
MethodsEighty patients with SanderⅡ-Ⅲ calcaneal fractures were selected and randomly divided into the tarsal sinus incision group and L-shaped incision group, with 40 cases in each group, and the patients were treated with modified tarsal sinus incision and expanded L-shaped incision plate fixation, respectively.The operation situation, recovery situation, postoperative complications and changes of ankle function at 12 months after operation were compared between the two groups.
ResultsThe operation time, intraoperative bleeding and postoperative hospital stay in the tarsal sinus incision group were significantly lower than those in the L-shaped incision group(P < 0.01), and there was no significant difference in fracture healing time between the two groups(P>0.05).The incidence of postoperative complications in the tarsal sinus incision group was 5.00%(2/40), which was lower than that of 22.50%(9/40) in the L-shaped incision group(P < 0.05).The Bohler angle, Gissane angle, middle calcaneal width and Mayfand score in the two groups were higher than those before operation(P < 0.05).The Mayfand score at one year after operation in the tarsal sinus incision group was significantly higher than that in the L-shaped incision group(P < 0.01).The excellent and good rate at one year after operation in the tarsal sinus incision group was 77.50%(31/40), which was higher than that of 60.00%(24/60) in the L-shaped incision group(P < 0.05).
ConclusionsThe curative effect of modified tarsal sinus incision for SanderⅡ-Ⅲ calcaneal fractures is better than that of expanded lateral calcaneal L-shaped incision plate fixation, and the former has faster postoperative recovery, lower incidence of complications and better recovery of foot function.

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