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[经跗骨窦入路微创锁定钢板治疗跟骨关节内骨折的疗效对比研究]

[Comparative study on curative effect of minimally invasive locking plate for the treatment of intra-articular calcaneal fractures via sinus tarsi approach].

作者信息

You Jiong-Ming, Wu Yin-Sheng, Wang Feng, Li Feng, Wang Yong

机构信息

Department of Orthopaedics, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang Chinese Medical University, Wenzhou, 325000, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2021 Sep 25;34(9):794-800. doi: 10.12200/j.issn.1003-0034.2021.09.002.

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 (<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 (>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.

摘要

目的

比较微创锁定钢板与解剖锁定钢板经跗骨窦入路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月采用跗骨窦入路手术治疗的48例跟骨关节内骨折患者。根据内固定方法不同,将患者分为微创锁定钢板组和解剖锁定钢板组。微创锁定钢板组男14例,女10例,年龄27~46岁,平均(38.70±5.58)岁,按Sanders分型Ⅱ型18例,Ⅲ型6例。解剖锁定钢板组男17例,女7例,年龄26~46岁,平均(37.10±6.44)岁,按Sanders分型Ⅱ型16例,Ⅲ型8例。比较两组手术时间、视觉模拟评分(VAS)、术后并发症,并记录两组术后1周及末次随访时的Böhler角、Gissane角、跟骨宽度和高度并进行比较。末次随访时根据Maryland足部功能评分评估功能效果。

结果

所有患者均获随访,时间为(14.10±1.94)个月(12~18个月)。所有患者均于8~16周获得骨性愈合,平均(10.60±2.25)周。微创锁定钢板组手术时间、VAS评分及并发症发生率分别为(69.50±7.51)min、(2.80±1.07)、2例,解剖锁定钢板组分别为(77.50±7.15)min、(3.80±1.09)、8例,两组比较差异有统计学意义(<0.05)。但两组术后1周及末次随访时Maryland足部功能评分、Böhler角、Gissane角、跟骨宽度和高度比较差异无统计学意义(>0.05)。

结论

与解剖锁定钢板相比,微创锁定钢板经跗骨窦入路治疗SandersⅡ、Ⅲ型跟骨关节内骨折,固定可靠,功能恢复相近,且手术操作更简单,手术时间短,术后疼痛轻,并发症少。

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