| No-touch技术与传统拉钩治疗跟骨骨折疗效及术后切口并发症比较 |
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Received:November 27, 2022
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| 作者 | Author | 单位 | Unit | E-Mail |
| 廖正文 |
LIAO Zheng-wen |
右江民族医学院附属西南医院暨百色市人民医院创伤骨科, 广西 百色 533000 |
Department of Orthopaedics Trauma, Southwest Hospital Affiliated to Youjiang Medical College for Nationalities and Baise People's Hospital, Baise 533000, Guangxi, China |
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| 黄承夸 |
HUANG Cheng-kua |
右江民族医学院附属西南医院暨百色市人民医院创伤骨科, 广西 百色 533000 |
Department of Orthopaedics Trauma, Southwest Hospital Affiliated to Youjiang Medical College for Nationalities and Baise People's Hospital, Baise 533000, Guangxi, China |
1244943047@qq.com |
| 陈仕 |
CHEN Shi |
右江民族医学院附属西南医院暨百色市人民医院创伤骨科, 广西 百色 533000 |
Department of Orthopaedics Trauma, Southwest Hospital Affiliated to Youjiang Medical College for Nationalities and Baise People's Hospital, Baise 533000, Guangxi, China |
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| 李炜 |
LI Wei |
百色市人民医院隆林分院外二科, 广西 百色 533400 |
Department of External Medicine, Longlin Branch, Baise People's Hospital, Baise 533400, Guangxi, China |
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| 期刊信息：《中国骨伤》2023年36卷，第4期，第302-308页 |
| DOI：10.12200/j.issn.1003-0034.2023.04.002 |
| 基金项目:右江民族医学院2020年度校级科研课题(编号:yy2020ky068) |
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目的： 比较No-touch技术与传统拉钩治疗跟骨骨折的临床疗效。
方法： 回顾性分析2019年7月至2021年6月治疗的74例闭合性SandersⅡ-Ⅳ型跟骨骨折患者的临床资料。根据治疗方法不同分为No-touch组和常规组,每组37例。No-touch组男25例,女12例;年龄19~70(42.64±14.16)岁;Sanders骨折分型,Ⅱ型17例,Ⅲ型14例,Ⅳ型6例;采用3枚2.0 mm克氏针分别于距骨体、距骨颈、骰骨植入折弯,将皮瓣向上翻转暴露术区完成手术。常规组男30例,女7例;年龄19~67(41.56±11.38)岁;Sanders骨折分型,Ⅱ型17例,Ⅲ型12例,Ⅳ型8例;采用传统拉钩暴露术区完成手术。比较两组患者手术时间、术后切口并发症发生率、术后6个月美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足评分。
结果： 两组74例患者均获得随访,No-touch组随访时间6~17(9.57±2.72)个月,常规组随访时间6~16(9.14±2.71)个月,两组比较差异无统计学意义(P>0.005)。No-touch组手术时间(55.67±7.94) min明显少于常规组(70.16±9.41) min (P<0.05);No-touch组术后2周出现切口并发症4例,而常规组则出现8例,差异有统计学意义(P<0.05)。No-touch组AOFAS评分中日常活动及支撑情况、最大步行距离、地面步行情况、屈伸伸展及内外翻受限程度、足部对线及总分明显高于常规组(P<0.05)。而两组在疼痛、反常步态、踝-后足稳定性方面比较,差异无统计学意义(P>0.005)。根据AOFAS评分,No-touch组优19例,良16例,差2例;常规组优9例,良24例,差4例;两组比较差异无统计学意义(P>0.005)。
结论： No-touch技术较传统拉钩治疗跟骨骨折,可明显缩短手术时间,降低术口并发症发生率,但两种方法均可提高术后踝关节功能恢复的优良率。 |
| [关键词]:跟骨骨折 No-touch 切口并发症 |
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| Comparison of clinical effect and postopertaive incisions between No-touch technique and traditional retractor in treating calcaneal fracture |
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Abstract:
Objective To compare clinical efficacy of No-touch technique and traditional retractor in treating calcaneal fracture.
Methods Clinical data of 74 calcaneal fracture patients with closed Sanders typeⅡ to Ⅳ were retrospectively analyzed from July 2019 to June 2021. According to different treatment methods,the patients were divided into No-touch group and conventional group,37 patinets in each group. In No-touch group,there were 25 males and 12 females,aged from 19 to 70 years old with an average of (42.64±14.16) years old;17 patients were typeⅡ,14 patinets with type Ⅲ,6 patients with type Ⅳ according to Sanders fracture classification;three 2.0 mm Kirschner wires were implanted into the talus body,talus neck,and cuboid bone,and the flap was turned upward to expose the operation area. In conventional group,there were 30 males and 7 females,aged from 19 to 67 years old with an average of (41.56±11.38) years old;17 patients with typeⅡ,12 patients with type Ⅲ,8 patients with type Ⅳ according to Sanders fracture classification;the operation was completed by exposing the operation area with traditional retractor. Operation time,postoperative incision complications,postoperaive American Orthopedic Foot and Ankle Society (AOFAS) ankle hind foot score at 6 months between two groups were compared.
Results Seventy-four patients were followed up,and follow-up time in No-touch group ranged from 6 to 17 months with an average of(9.57±2.72) months,while in conventional group ranged from 6 to 16 months with an averge of(9.14±2.71) months,and no difference in follow-up between two groups (P>0.005). Operation time in No-touch group (55.67±7.94) min was shorter than that in conventional group (70.16±9.41) min (P<0.05);four patients in No-touch group occurred incision complications,while 8 patients in normal group,and had statistically difference(P<0.05). Daily activities and support,maximum walking distance (block),ground walking,limited degree of flexion,extension and valgus,foot alignment and total score of AOFAS scores in No-touch group was significantly higher than that of conventional group (P<0.05). There were no significant difference in pain degree,abnormal gait and ankle hind foot stability between two groups(P>0.005). According to AOFAS score,19 patients got excellent result,16 good and 2 poor in No-touch group;while 9 excellent,24 good,and 4 poor in conventional group,and no difference between two groups (P>0.005).
Conclusion Compared with traditional retractor in treating calcaneal fracture,No-touch technology could significantly shorten operation time,reduce incidence of postopertive complications,while two methods could improve excellent and good rate of ankle joint function recovery after operation. |
| KEYWORDS:Calcaneal fractures No-touch Incision complications |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 廖正文,黄承夸,陈仕,李炜.No-touch技术与传统拉钩治疗跟骨骨折疗效及术后切口并发症比较[J].中国骨伤,2023,36(4):302~308 |
| 英文格式: | LIAO Zheng-wen,HUANG Cheng-kua,CHEN Shi,LI Wei.Comparison of clinical effect and postopertaive incisions between No-touch technique and traditional retractor in treating calcaneal fracture[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(4):302~308 |
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