| 外侧改良切口与传统“L”形延长切口治疗跟骨关节内骨折病例对照研究 |
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投稿时间：2010-04-23
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| 作者 | Author | 单位 | Address | E-Mail |
| 严盈奇 |
YAN Ying-qi |
浙江大学医学院附属邵逸夫医院骨科，浙江 杭州 310016
嘉兴市第二医院骨科 |
Sir Run Run Shaw Hospital, Zhejiang University School of Medicine Orthopedic, Hangzhou 310016, Zhejiang, China |
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| 范顺武 |
FAN Shun-wu |
浙江大学医学院附属邵逸夫医院骨科，浙江 杭州 310016 |
Sir Run Run Shaw Hospital, Zhejiang University School of Medicine Orthopedic, Hangzhou 310016, Zhejiang, China |
fansw@srrsh.com |
| 黄悦 |
HUANG Yue |
浙江大学医学院附属邵逸夫医院骨科，浙江 杭州 310016 |
Sir Run Run Shaw Hospital, Zhejiang University School of Medicine Orthopedic, Hangzhou 310016, Zhejiang, China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第11期，第810-813页 |
| DOI：10.3969/j.issn.1003-0034.2010.11.004 |
| 基金项目: |
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中文摘要:
目的：比较外侧改良切口与传统“L”形延长切口两种不同入路治疗跟骨关节内移位骨折的临床效果。
方法：回顾性分析2005年1月至2008年1月分别采用外侧改良切口与传统“L”形延长切口治疗的36例跟骨关节内移位骨折患者。其中外侧改良切口组(A组)19例，男12例，女7例；年龄(38.1±9.1)岁；骨折按Sanders分型：Ⅱ型8例，Ⅲ型9例，Ⅳ型2例；伤后至手术时间(10.5±1.7) d.传统“L”形延长切口组(B组)17例，男11例，女6例；年龄(38.4±7.3)岁；骨折按Sanders分型：Ⅱ型7例，Ⅲ型9例，Ⅳ型1例；伤后至手术时间(10.6±1.8) d.观察比较两组患者：①手术时间、失血量、切口长度、植骨例数；②术后第1天VAS疼痛评分；③切口愈合情况；④Maryland足部评分；⑤术后影像学结果进行对比分析。
结果：两组患者均获得随访，时间10～15个月，平均11个月。两组患者手术时间、植骨例数比较，差异无统计学意义(P>0.05).手术失血量A组(94.0±9.5) ml、B组(109.9±13.7) ml,切口长度A组(6.8±1.1) cm、B组(15.7±2.2) cm,差异均有统计学意义(P<0.05).术后第1天VAS疼痛评分A组(1.95±0.71)分、 B组(3.65±1.00)分，差异有统计学意义(P<0.05).切口愈合A组1例乙级愈合，B组6例乙级愈合，均经延长换药时间愈合，差异有统计学意义(P<0.05).两组患者Maryland足部评分、末次随访时影像学比较差异均无统计学意义(P>0.05).
结论：外侧改良切口与传统“L”形延长切口治疗跟骨关节内骨折的总体疗效相当，但外侧改良切口具有切口较小、手术创伤小、切口并发症较少的优点。 |
| 【关键词】跟骨 骨折 骨折内固定术，内 临床对照试验 |
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| Effective comparison between improved lateral incision and the traditional L-shaped extension incision in treatment of intra-articular calcaneal fractures |
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ABSTRACT
Objective: To compare the clinical outcome between the two different approaches of improved lateral incision and the traditional L-shaped extension incision to treat intra-articular calcaneal fractures.
Methods: From January 2005 to January 2008,36 cases of intra-articular calcaneal fractures were treated by improved lateral incision or the traditional L-shaped extension incision. In improved lateral incision group,there were 19 cases including 12 males and 7 females with an average age of(38.1±9.1) years;According to Sanders classification:8 cases were typeⅡ，9 were type Ⅲ，2 were type Ⅳ；The time from injury to the operation was(10.5±1.7)days. In the traditional L-shaped extension incision group,there were 17 cases including 11 males and 6 females with an average age of (38.4±7.3)years;according to Sanders classification of fractures:7 cases were typeⅡ，9 were typeⅢ，1 was typeⅣ；The time from injury to the operation was(10.6±1.8)days. Observing and comparing some items of the two groups including ①operation time,blood loss,incision length,number of graft cases,② VAS pain scores after the first day,③ wound healing,④ Maryland foot scoring,⑤postoperative imaging results were comparative analyzed.
Results: Two groups of patients were followed up from 10 to 15 months with an average of 11 months. The operative time and number of graft cases were compared between two groups with no statistically significant differences. The blood loss were(94.0±9.5) ml in improved lateral incision group and(109.9±13.7) ml in L-shaped extension incision group,incision length were(6.8±1.1) cm in improved lateral incision group and(15.7±2.2) cm in L-shaped extension incision group with significant differences. Postoperative VAS pain score at the first day were(1.95±0.71) points in improved lateral incision group and (3.65±1.00) points in L-shaped incision group with significant difference. In improved lateral incision group there was 1 case of grade B wound healing,and in the traditional L-shaped extension incision group,there were 6 cases of grade B wound healing,these patients were healing by protensive time for change dress.
Conclusion: These two incision of improved lateral incision and the traditional L-shaped extension incision for treating the intra-articular calcaneal fractures are therapeutic equivalence. However,improved lateral incision has advantage of small incision and operative wound,and fewer wound complications. |
| KEY WORDS Calcaneus Fractures Fracture fixation,internal Controlled clinical trials |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 严盈奇,范顺武,黄悦.外侧改良切口与传统“L”形延长切口治疗跟骨关节内骨折病例对照研究[J].中国骨伤,2010,23(11):810~813 |
| 英文格式: | YAN Ying-qi,FAN Shun-wu,HUANG Yue.Effective comparison between improved lateral incision and the traditional L-shaped extension incision in treatment of intra-articular calcaneal fractures[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(11):810~813 |
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