两种不同的切口治疗跟骨骨折的临床对比分析

何嘉承

【摘要】 目的：比较跗骨窦与外侧“L”形入路内固定治疗跟骨骨折的效果。方法：回顾性分析2013年

1月-2020年1月九江市第一人民医院骨科收治的54例跟骨骨折患者的临床资料，其中，采取经跗骨窦入路内固定治疗者27例标记为观察组，经外侧“L”形入路内固定治疗者27例标记为参照组，比较两组患者围术期情况、不良事件发生率以及术后随访情况。结果：观察组的术前准备时间（3.86±0.62）d、

手术时间（58.56±13.61）min、術中出血量（30.31±6.27）mL及术后住院时间（7.24±2.13）d均明显少于参照组（7.64±1.76）d、（75.72±15.46）min、（59.55±10.78）mL、（10.63±2.03）d，差异均有统计学意义（P<0.05）;观察组的不良事件发生率为3.70%（1/27），低于参照组的25.93%（7/27），差异有统计学意义（P<0.05）;术后12个月回访，观察组患者的疼痛发生率低于参照组，差异有统计学意义（P<0.05）。结论：与外侧“L”形入路内固定治疗相比，采用跗骨窦入路插入锁定钢板治疗跟骨骨折更为安全、有效，值得临床推广及应用。

【关键词】 跗骨窦 外侧“L”形入路 内固定治疗 跟骨骨折

Clinical Comparative Analysis of Two Different Incisions in the Treatment of Calcaneal Fractures/HE Jiacheng. //Medical Innovation of China， 2021， 18（35）： 0-042

[Abstract] Objective： To compare the effects of internal fixation between sinus tarsi and lateral “L” shaped approach in the treatment of calcaneal fractures. Method： A retrospective analysis of the clinical data of 54 patients with calcaneal fractures admitted to the Department of Orthopedics， Jiujiang NO.1 People’s Hospital from January 2013 to January 2020， of which 27 cases were treated with internal fixation via the sinus tarsi approach were marked as in the observation group， 27 patients treated with internal fixation via the lateral “L” shaped approach were marked as the reference group. The perioperative situation， the incidence of adverse events， and the postoperative follow-up were compared between the two groups. Result： The preoperative preparation time （3.86±0.62） d，

operation time （58.56±13.61） min， intraoperative blood loss （30.31±6.27） mL and postoperative hospital stay （7.24±2.13） d of the observation group were significantly less than （7.64±1.76） d， （75.72±15.46） min，

（59.55±10.78） mL， （10.63±2.03） d of the reference group， the differences were statistically significant （P<0.05）; the incidence of adverse events in the observation group was 3.70% （1/27）， lower than 25.93% （7/27） of the reference group， the difference was statistically significant （P<0.05）; 12 months after surgery， the incidence of pain in the observation group was lower than that in the reference group， the difference was statistically significant （P<0.05）. Conclusion： Compared with the internal fixation treatment through the lateral “L” shaped approach， the sinus tarsi approach to insert the locking plate for the treatment of calcaneal fractures is safer and more effective， and it is worthy of clinical promotion and application.

[Key words] Sinus tarsi Lateral “L” shaped approach Internal fixation Calcaneal fractures

First-author’s address： Jiujiang NO.1 People’s Hospital， Jiujiang 332000， China

doi：10.3969/j.issn.1674-4985.2021.35.010

跟骨骨折是临床上较为多发的足部骨折之一，主要是由高处坠落、交通事故、重物挤压等外力创伤因素及其他因素下导致的足跟处骨骼受到破坏，患者主要表现为足跟部出现明显的肿大及疼痛、皮下瘀斑、足跟部外翻畸形、足底扁平、不能正常行走等症状[1]。对于病情较轻，没有波及距下关节、骨折处移位不大的患者，一般可进行手法复位后采用石膏对骨折部位进行固定，对于病情较重，已波及距下关节、骨折处移位明显的患者，则需要进行手术治疗纠正足跟部畸形和恢复足部正常功能[2]。……