邓乐章

【摘要】 目的：分析跟骨骨折接受经跗骨窦小切口与外侧L切口治疗的临床效果。方法：选取笔者所在医院2015年3月-2018年2月收治的80例跟骨骨折患者为研究对象，随机分为两组，对照组采用传统外侧L切口内固定术治疗，观察组采用经跗骨窦小切口结合手法整复内固定术治疗，对比两组手术前后Gissane角、Bohler角、美国足踝学会踝与后足功能评分（AOFAS）及并发症发生情况。结果：与对照组比较，观察组术后AOFAS评分更高，差异有统计学意义（t=8.999 8，P<0.05）;与对照组比较，观察组术后Gissane角与Bohler角更大，差异均有统计学意义（t=8.558 9、10.025 8，P<0.05）;与对照组并发症发生率22.5%比较，观察组的5.00%更低，差异有统计学意义（字2=5.164 7，P<0.05）。结论：跟骨骨折采用经跗骨窦小切口结合手法整复内固定术治疗的临床效果优于传统外侧L切口内固定术。

【关键词】 跟骨骨折 经跗骨窦小切口 外侧L切口 临床疗效

doi：10.14033/j.cnki.cfmr.2019.28.006 文献标识码 B 文章编号 1674-6805（2019）28-00-03

Calcaneal Fracture Treated with Small Incision of the Sacral Sinus and Lateral L Incision/DENG Lezhang. //Chinese and Foreign Medical Research， 2019， 17（28）： -17

[Abstract] Objective： To analyze the clinical effect of treatment of calcaneal fractures with small incision through the sacral sinus and lateral L incision. Method： Eighty patients with calcaneal fractures from March 2015 to February 2018 in our hospital were enrolled in the study. They were randomly divided into two groups. The control group was treated with conventional lateral L incision internal fixation， and the small incision through the sacral sinus combined with manual internal fixation was used in the observation group. The changes of Gissane angle， Bohler angle， American foot and ankle function and hindfoot function score （AOFAS） before and after surgery， and the complications of the two groups were compared. Result： Compared with the control group， the AOFAS score was higher in the observation group， and the difference was statistically significant （t=8.999 8， P<0.05）. Compared with the control group， the postoperative Gissane angle and Bohler angle were higher in the observation group， the differences were statistically significant （t=8.558 9， 10.025 8， P<0.05）. The incidence of complications of the control group was 22.5%， which in the observation group was 5.00%， lower than that of the control group， and the difference was statistically significant （字2=5.164 7， P<0.05）. Conclusion： The clinical effect of small incision through the sacral sinus combined with manual internal fixation for calcaneus fracture is better than traditional lateral L incision internal fixation.

[Key words] Calcaneal fracture Small incision through the sacral sinus Lateral L incision Clinical efficacy

First-authors address： Xiantao First Peoples Hospital， Xiantao 433000， China

臨床上，跟骨骨折属于一种发病率较高的骨折类型，其中关节内骨折占85%～90%，致伤原因主要为交通伤或者高处坠落伤[1]。因跟骨具有错综复杂的解剖结构，且足弓主要成分为跟骨，所以手术解剖复位难度大，同时术后具有较高并发症发生率，不利于改善患者预后[2-3]。跟骨骨折主要为SandersⅡ、Ⅲ型，以往临床通常会采用传统外侧L切口内固定术对患者进行治疗，但具有较高并发症发生率，所以其临床应用也在一定程度上受到限制[4]。近年来，随着医学微创理念不断推广，微创手术也被广泛应用于跟骨骨折治疗中[5-6]。本研究在跟骨骨折治疗中采用了经跗骨窦小切口内固定术，并将其应用结果与外侧L切口内固定术对比，现报道如下。

1 资料与方法

1.1 一般资料

选取2015年3月-2018年2月来笔者所在医院接受治疗的80例跟骨骨折患者，纳入标准：（1）不存在手术禁忌证;（2）依从性高;（3）确诊为跟骨SandersⅡ、Ⅲ型骨折。……