不同术式治疗跟骨骨折的综合疗效对比

穆臣会

[摘要] 目的 探讨手法复位微创切口钢板内固定术对跟骨骨折患者的临床治疗效果。方法 临床方便选取76例2013年7月—2015年6月该院收治的跟骨骨折患者进行研究，根据治疗不同分为A、B两组各38例。其中B组采用“L”形切口切开复位钢板内固定术进行治疗，A组则采用手法复位跗骨窦微创入路钢板内固定术进行治疗，治疗结束后，分析对比两组治疗后并发症情况以及治疗效果情况。结果 A组患者治疗后并发症发生仅为5.26%，明显低于B组的39.47%（P<0.05）。A组治疗优良率高达94.75%，明显高于B组的52.63%（P<0.05）。结论 采用手法复位微创切口钢板内固定术治疗跟骨骨折疗效较好，在减少并发症发生率的同时还有有效促进治疗效果，患者恢复较佳，值得临床应用及推广。

[关键词] 不同术式；治疗；跟骨骨折；综合疗效

[中图分类号] R68 [文献标识码] A [文章编号] 1674-0742（2017）05（c）-0062-03

[Abstract] Objective To study the clinical effect of manual reduction and minimally invasive plate internal fixation in the treatment of calcaneus fracture. Methods 76 cases of patients with calcaneus fractures in our hospital from July 2013 to June 2015 were convenient selected and divided into two groups with 38 cases in each according to different treatment， the group B were treated with L open reduction and plate internal fixation， while the group A were treated with manual reduction of minimally invasive approach for the treatment of tarsal sinus， at the end of treatment， the complications and treatment effect of the two groups were compared and analyzed. Results The incidence rate of complications in the group A after treatment was obviously lower than that in the group B（5.26% vs 39.47%）（P<0.05）， and the excellent and good rate in the group A was obviously higher than that in the group B（94.75% vs 52.63%）（P<0.05）. Conclusion The curative effect of manual reduction and minimally invasive plate internal fixation in the treatment of calcaneus fracture is better， which can reduce the incidence rate of complications but also promote the treatment effect with better recovery， and it is worth clinical application and promotion.

[Key words] Different operation methods； Treatment； Calcaneus fracture； Comprehensive curative effect

跟骨骨折是临床骨科常见疾病之一，多由骨质疏松以及髋周肌肉群退行性改变等，因此常见于中老年群体，青年群体发生跟骨骨折的主要因素主要因为严重外伤导致，若不及时治疗，延误病情会导致患者生活质量下降，严重影响患者健康安全。临床上有保守治疗和手术治疗两种方法，既往研究表明[1]，采用内、外固定的保守治疗方法不能有效促进股骨头愈合情况，可能导致股骨头缺血坏死，仅有25%左右的患者可在保守治疗中痊愈。因此临床以手术为跟骨骨折治疗的主要方式。既往多采用“L”型入路切口对跟骨骨折患者进行治疗，虽然有较好治疗效果，但据临床研究发现[2]，“L”型治疗术后患者易发生皮肤切口感染，影响治疗效果。目前研究认为[3]，正确的干预方案可有效降低术后切口感染发生率，从而提高治疗效果。因此该文对该院2013年7月—2015年6月期间收治的76例跟骨骨折患者进行研究，效果满意，现报道如下。……