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| Clinical Study of Minimally Invasive Sacral Sinus Approach for Sanders Type Ⅱ Calcaneal Fracture |
| ZHANG Hua, YANG Wang-li |
| Department of Joint Orthopedics, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang Shaanxi, 712000 |
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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.
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Received: 29 October 2020
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[1] 陈继铭, 钟环, 冯柏淋. 跟骨骨折Sanders分型数字化模型的初步建立[J].中华解剖与临床杂志, 2015, 20(3):196-199.
[2] 付尧. SandersⅡ~Ⅲ型跟骨骨折术后完全负重练习开始时间与足部功能关系[J].中华骨与关节外科杂志2015,7(1):62-65.
[3] 宋兵华, 孙俊英, 倪增良, 等. 影响移位关节内跟骨骨折手术疗效的因素[J].中华创伤杂志, 2015, 31(10):941-946.
[4] 梅晓龙, 曾宪铁, 舒衡生. Ilizarov技术与切开复位内固定治疗跟骨骨折的疗效比较[J].中华骨科杂志, 2016, 36(9):528-533.
[5] 陈志军, 朱东波, 王树金, 等. 跗骨窦切口钢板螺钉治疗SandersⅡ、Ⅲ型跟骨骨折[J].临床骨科杂志, 2017, 20(2):220.
[6] 张涛. Orthofix外固定支架治疗跟骨关节内骨折的技巧及疗效分析[J].中华创伤骨科杂志, 2016, 18(12):1040-1045.
[7] Park CH.Surgical treatment of sanders type 2 calcaneal fractures using a sinus tarsi approach[J]. Indian J Orthop, 2017, 51(4):461.
[8] 梁伟, 邹光翼, 王济纬, 等自制双边三角形万向可伸缩外固定支架治疗开放性关节内粉碎性跟骨骨折[J].中华创伤骨科杂志, 2016, 18(9):809-813.
[9] 罗长奇, 方跃, 屠重棋,等. 闭合性跟骨骨折手术部位感染的危险因素分析[J].中华创伤骨科杂志, 2016, 18(12):1096-1099.
[10] 肖凯. 跗骨窦小切口及经皮复位固定治疗SandersⅡ、Ⅲ型跟骨骨折[J].中华骨科杂志, 2018, 38(15):905-912.
[11] 潘永雄, 洪劲松, 付小勇, 等. 经跗骨窦切口与经外侧L型切口治疗跟骨骨折在内侧壁与跟骨力线的比较研究[J].中华创伤骨科杂志, 2018, 20(12):1095.
[12] 李元洲, 杨茂伟, 刘贺国,等. 经踝关节前内侧入路治疗距骨骨折[J].中华骨科杂志, 2019, 39(5):298-304. |
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2021, Vol. 38 
