Yang Bin, Wang De-Cheng, Zhang Xing-Guo, Wang Zhong-Wei
Tongzhou Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 101100, China;
Tongzhou Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 101100, China.
Zhongguo Gu Shang. 2018 Jul 25;31(7):599-603. doi: 10.3969/j.issn.1003-0034.2018.07.003.
To investigate clinical effects of improved anatomical locking plate internal fixation through tarsal sinus incision in treating Sanders III and IV calcaneal fractures.
From February 2015 to October 2016, 35 patients with Sanders III and IV calcaneal fractures treated by improved anatomical locking plate internal fixation through tarsal sinus incision were collected, including 22 males and 13 females aged from 22 to 68 years old with an average of (42.3±12.7) years old. According to Sanders classification, 23 patients were type III and 12 patients were type IV. Postoperative complications were observed, Bö hler angle and Gissane angle before and after operation were compared, and Maryland foot function scoring standard was evaluated at 12 months after operation.
All patients were followed up from 12 to 20 months with an average of (14.5±2.0) months, the length of incision ranged from 4.0 to 5.5 cm with an average of (4.7±0.4) cm. Superficial infection occurred in 1 patient, delayed union in 2 patients, gastrocnemius nerve injury in 1 patient. No complications such as steel plate exposure and fracture reduction loss occurred. Wound healing time ranged from 14 to 28 days with an average of(15.4±4.7) days, the fracture healing time ranged from 8 to 14 weeks with an average of (9.8±1.9) weeks. Bö hler angle increased from preoperative (9.81±14.28)° to 3 days after operation (26.35±11.04)°, and (25.96±10.79)° at 12 months after operation(<0.05). Gissane angle ranged from preoperative (122.54±16.79)° to 3 days after operation (120.85±11.88)°, and (120.62±11.44)° at 12 months after operation and had statistical meaning. Maryland score increased from 12.66±4.10 before operation to 92.20 ±7.82 at 12 months after operation, and 32 patients got excellent results, 2 good and 1 moderate.
Improved anatomical locking plate internal fixation through tarsal sinus incision in treating Sanders III and IV calcaneal fractures, which has advantages of less incision, less soft tissue injury, better fracture reduction and fixation, could receive good reduction and fixation. It is an effective method for Sanders III and IV fracture of calcaneus fracture.
探讨经跗骨窦切口改良解剖型锁定钢板内固定治疗SandersⅢ、Ⅳ型跟骨骨折的临床疗效。
收集2015年2月至2016年10月采用经跗骨窦切口改良解剖型锁定钢板内固定治疗的35例SandersⅢ、Ⅳ型跟骨骨折患者，其中男22例，女13例，年龄22～68岁，平均（42.3±12.7）岁。按Sanders分型，Ⅲ型23例，Ⅳ型12例。观察术后并发症，比较手术前后的Böhler角和Gissane角，并于术后12个月采用Maryland足部功能评分标准进行评价。
所有患者随访12～20个月，平均（14.5±2.0）个月，切口长度4.0～5.5 cm，平均（4.7±0.4）cm。发生浅表感染1例，延迟愈合2例，腓肠神经损伤1例。未发生钢板外露、骨折复位丢失等并发症。伤口愈合时间14～28天，平均（15.4±4.7）天，骨折愈合时间8～14周，平均（9.8±1.9）周。Böhler角由术前（9.81±14.28）°增加至术后3天（26.35±11.04）°，术后12个月为（25.96±10.79）°（P<0.05）。Gissane角由术前（122.54±16.79）°变为术后3天（120.85±11.88）°，术后12个月为（120.62±11.44）°，差异有统计学意义。Maryland评分由术前12.66±4.10提高至术后12个月92.20±7.82，优32例，良2例，可1例。
经跗骨窦切口改良解剖型锁定钢板内固定治疗SandersⅢ、Ⅳ型跟骨骨折，具有切口小、软组织损伤小、骨折复位固定效果好等优点，能获得良好的复位固定，是治疗SandersⅢ、Ⅳ型跟骨骨折的有效方法。
