| 经跗骨窦入路微创锁定钢板治疗跟骨关节内骨折疗效对比研究 |
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投稿时间：2020-06-01
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| 作者 | Author | 单位 | Address | E-Mail |
| 尤炯鸣 |
YOU Jiong-ming |
浙江中医药大学附属温州中西医结合医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang Chinese Medical University, Wenzhou, 325000, Zhejiang, China |
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| 吴银生 |
WU Yin-sheng |
浙江中医药大学附属温州中西医结合医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang Chinese Medical University, Wenzhou, 325000, Zhejiang, China |
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| 王锋 |
WANG Feng |
浙江中医药大学附属温州中西医结合医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang Chinese Medical University, Wenzhou, 325000, Zhejiang, China |
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| 李峰 |
LI Feng |
浙江中医药大学附属温州中西医结合医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang Chinese Medical University, Wenzhou, 325000, Zhejiang, China |
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| 王勇 |
WANG Yong |
浙江中医药大学附属温州中西医结合医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang Chinese Medical University, Wenzhou, 325000, Zhejiang, China |
wy118@163.com |
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| 期刊信息：《中国骨伤》2021年，第34卷，第9期，第794-800页 |
| DOI：10.12200/j.issn.1003-0034.2021.09.002 |
| 基金项目:温州市科技计划项目（编号：Y20180324） |
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中文摘要:
目的：比较经跗骨窦入路使用微创锁定钢板与解剖型锁定钢板治疗跟骨关节内骨折的临床疗效。
方法：回顾性分析2016年7月至2017年6月采用跗骨窦入路治疗的48例跟骨关节内骨折患者的临床资料，根据内固定方式不同分为微创锁定钢板组和解剖型锁定钢板组，每组24例。微创锁定钢板组，男14例，女10例；年龄27~46（38.70±5.58）岁；骨折Sanders分型，Ⅱ型18例，Ⅲ型6例。解剖型锁定钢板组，男17例，女7例；年龄26~46（37.10±6.44）岁；骨折Sanders分型，Ⅱ型16例，Ⅲ型8例。观察并比较两组患者手术时间，视觉模拟评分（visual analague scale，VAS），术后并发症情况，比较术后1周及末次随访时Böhler角、Gissane角、跟骨宽度和高度变化情况，采用Maryland足部功能评分进行功能评价。
结果：所有患者获得随访，时间12~18（14.10±1.94）个月。48例患者获得骨性愈合，愈合时间8~16（10.60±2.25）周。微创锁定钢板组手术时间、VAS评分、并发症分别为（69.50±7.51） min、（2.80±1.07）分、2例，解剖型锁定钢板组分别为（77.50±7.15） min、（3.80±1.09）分、8例，两组比较差异有统计学意义（P<0.05）。两组术后1周及末次随访时Böhler角、Gissane角、跟骨宽度、高度比较差异无统计学意义（P>0.05）。两组Maryland足部功能评分比较差异无统计学意义（P>0.05）。
结论：对于SandersⅡ、Ⅲ型跟骨关节内骨折，经跗骨窦入路使用微创锁定钢板治疗可以达到与解剖型锁定钢板相似的牢靠固定及功能恢复，其操作更简便，手术时间更短，术后早期疼痛更轻，术后并发症更少。 |
| 【关键词】跟骨 骨折固定术,内 微创外科手术 病例对照研究 |
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| Comparative study on curative effect of minimally invasive locking plate for the treatment of intra-articular calcaneal fractures via sinus tarsi approach |
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ABSTRACT
Objective: To compare clinical efficacy of minimally invasive locking plate and anatomic locking plate in treating intra-articular calcaneal fractures via sinus tarsi approach.
Methods: A retrospective analysis was conducted of 48 patients with intra-articular calcaneal fractures treated with surgery via sinus tarsi approach from July 2016 to June 2017. According to differernt methods of internal fixation,the patients were divided into minimally invasive locking plate group and anatomic locking plate group. In minimally invasive locking plate group,there were 14 males and 10 females,aged from 27 to 46 years old with an average age of(38.70±5.58) years old,18 patients were typeⅡand 6 patients were type Ⅲ according to Sanders classification. In anatomic locking plate group,there were 17 males and 7 females,aged from 26 to 46 years old with an average age of (37.10±6.44) years old,16 patients were typeⅡ and 8 patients were type Ⅲ according to Sanders classification. Operative time,visual analogue scale (VAS),postoperative complications between two groups were compared,and Böhler angle,Gissane angal,calcaneal width and height were recorded and compared between two groups at 1 week after operation and final follow-up. The functional effect was assessed according to Maryland foot function score at final follow-up.
Results: All patients were followed up for (14.10±1.94) months (ranged 12 to 18 months). All patients were obtained bone union from 8 to 16 weeks with an average of (10.60±2.25) weeks. Operation time,VAS score and complication rate in minimally invasive locking plate group were (69.50±7.51) min,(2.80±1.07) and 2 cases respectively,and (77.50±7.15) min,(3.80±1.09) and 8 cases in anatomic locking plate group respectively,there were statistical difference between two groups (P<0.05). However,there were no statistically differences in Maryland foot function score,Böhler angle,Gissane angle,calcaneal width and height at 1 week after opertaion and final follow-up between two groups (P>0.05).
Conclusion: Compare with anatomic locking plate,minimally invasive locking plate via sinus tarsi approach for Sanders typeⅡ and Ⅲ intra-articular calcaneal fractures could obtain similar reliable fixation and functional recovery with more simple operation,shorter operative time,lighter postoperative pain and less complications. |
| KEY WORDS Calcaneus Fracture fixation,internal Minimal surgical procedure Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 尤炯鸣,吴银生,王锋,李峰,王勇.经跗骨窦入路微创锁定钢板治疗跟骨关节内骨折疗效对比研究[J].中国骨伤,2021,34(9):794~800 |
| 英文格式: | YOU Jiong-ming,WU Yin-sheng,WANG Feng,LI Feng,WANG Yong.Comparative study on curative effect of minimally invasive locking plate for the treatment of intra-articular calcaneal fractures via sinus tarsi approach[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(9):794~800 |
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