摘要【目的】探讨跗骨窦入路微创手术治疗SandersⅡ型跟骨骨折的临床疗效。【方法】选取2013年3月至2019年6月在陕西中医药大学附属医院诊治的60例确诊为SandersⅡ型跟骨骨折患者作为研究对象,按随机数表法分为观察组和对照组,每组30例。对照组给予跟骨外侧入路手术治疗,观察组给予跗骨窦入路微创手术治疗。对比两组患者手术相关情况、跟骨结节关节角(Bohler角)、跟骨前后关节面之间的夹角(Gissane角)测量值、踝与后足功能评分(AOFAS)及术后并发症发生情况。【结果】观察组手术时间、住院时间均明显短于对照组,切口长度、术中出血量均小于对照组( P <0.05);两组术后Bohler角和Gissane角大于术前( P <0.05),且观察组Bohler大于对照组( P <0.05),但两组术后Gissane角比较差异无统计学意义( P >0.05);观察组AOFAS评分优良率为90.00%,显著高于对照组的 66.66%,其差异有统计学意义( χ2 =4.812, P =0.028);观察组术后并发症发生率为13.34%,明显低于对照组的36.66%,其差异有统计学意义( χ2 =4.356, P =0.037)。【结论】与跟骨外侧入路手术治疗相比,跗骨窦入路微创手术治疗SandersⅡ型跟骨骨折疗效显著,可有效降低术后并发症,值得临床推广应用。
Abstract：【Objective】To analyze the effectiveness of minimally invasive sacral sinus approach for Sanders type Ⅱ calcaneal fractures. 【Methods】 A total of 60 patients who were diagnosed as Sanders type Ⅱ calcaneal fractures patients in Shaanxi University of Traditional Chinese Medicine Hospital from March 2013 to June 2019 were selected as the research subjects. According to the stochastic indicator method, patients were divided into the observation group and the control group, with 30 cases in each group. The control group was treated with lateral calcaneus approach, while the observation group was treated with minimally invasive surgery through the tarsal sinus approach. Surgical conditions, Bohler Angle, Gissane Angle, ankle and posterior foot functional scores (AOFAS), postoperative complications were compared between the two groups. 【Results】The operation time and average hospitalization time in the observation group were significantly shorter than those in the control group, the incision length and intraoperative blood loss in the observation group were significantly less than those in the control group ( P <0.05). The postoperative Bohler Angle and Gissane Angle in the two groups were higher than those before the operation. The Bohler Angle in the observation group was larger than that in the control group ( P <0.05), but there was no significant difference in Gissane Angle between the two groups after operation ( P >0.05). The excellent and good rate of AOFAS in the observation group was higher than that in the control group (90.00% vs 66.66%) ( χ2 =4.812, P =0.028). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (13.34%vs36.66%) ( χ2 =4.356, P=0.037). 【Conclusion】Compared to the surgical treatment of lateral calcaneal approach, minimally invasive surgery of sacral sinus approach for Sanders type Ⅱ calcaneal fracture has achieved significant clinical efficacy, high safety, and can effectively reduce postoperative complications.
2021, Vol. 38 
