何嘉承 喻巍 李超 周欢斌 万良弈 万俊良 李强 付江明

【摘要】 目的：探討改良经跗骨窦“八”字切口与传统“L”型切口治疗Sanders Ⅱ、Ⅲ型跟骨骨折的效果及安全性。方法：选取2017年3月-2021年3月本院收治的50例Sanders Ⅱ、Ⅲ型跟骨骨折患者，将其随机分为对照组和研究组，每组25例。对照组给予传统“L”型切口治疗，研究组给予改良经跗骨窦“八”字切口治疗。比较两组并发症发生情况、临床各指标变化情况、足部功能情况以及Bohler角、Gissane角。结果：研究组术后6个月的足部功能优良率明显高于对照组，差异有统计学意义（P<0.05）。术前和术后6个月，两组Bohler角、Gissane角比较，差异均无统计学意义（P>0.05）;术后6个月，两组Bohler角、Gissane角均较术前明显增大（P<0.05）。研究组并发症发生率明显低于对照组，差异有统计学意义（P<0.05）。研究组术中出血量及术后VAS评分均低于对照组，手术时间及骨折愈合时间均明显短于对照组，差异均有统计学意义（P<0.05）。结论：Sanders Ⅱ、Ⅲ型跟骨骨折患者接受改良经跗骨窦“八”字切口及传统“L”型切口治疗均具有一定的效果，但前者能使手术时间及骨折愈合时间有效缩短，降低并发症发生率，还能使患者的疼痛感明显减轻，可推广使用。

【关键词】 改良经跗骨窦“八”字切口 传统“L”型切口 Sanders Ⅱ、Ⅲ型 跟骨骨折

Comparison of the Effect and Safety of Modified Trans-tarsal Sinus “八” Incision and Traditional “L” Incision in the Treatment of Sanders Ⅱ and Ⅲ Calcaneal Fractures/HE Jiacheng， YU Wei， LI Chao， ZHOU Huanbin， WAN Liangyi， WAN Junliang， LI Qiang， FU Jiangming. //Medical Innovation of China， 2021， 18（33）： 0-040

[Abstract] Objective： To investigate the effect and safety of modified trans-tarsal sinus “八” incision and traditional “L” incision in the treatment of Sanders Ⅱ and Ⅲ calcaneal fractures. Method： A total of 50 patients with calcaneal fractures of Sanders Ⅱ and Ⅲ treated in our hospital from March 2017 to March 2021 were selected， and they were randomly divided into control group and study group， 25 cases in each group. The control group was treated with traditional “L” incision， and the study group was treated with modified trans-tarsal sinus “八” incision. The incidence of complications， changes of clinical indicators， foot function， Bohler angle and Gissane angle were compared between the two groups. Result： The excellent and good rate of foot function in the study group 6 months after surgery was significantly higher than that in the control group， the difference was statistically significant （P<0.05）. There were no significant differences in Bohler angle and Gissane angle between the two groups before surgery and 6 months after surgery （P>0.05）. 6 months after surgery， Bohler angle and Gissane angle in both groups were significantly increased compared with those before surgery （P<0.05）. The complication rate of the study group was significantly lower than that of the control group， the difference was statistically significant （P<0.05）. The amount of intraoperative blood loss and postoperative VAS score in the study group were lower than those in the control group， and the operation time and fracture healing time were significantly shorter than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Sanders Ⅱ and Ⅲ calcaneal fracture patients receiving the modified trans-tarsal sinus “八” incision and traditional “L” incision have certain effects， but the former can effectively shorten the operation time and fracture healing time， reduce the incidence of complications， and significantly reduce the pain of patients， which can be popularized.

[Key words] Modified trans-tarsal sinus “八” incision Traditional “L” incision Sanders Ⅱ and Ⅲ Calcaneal fracture

First-author’s address： Jiujiang First People’s Hospital， Jiujiang 332000， China

doi：10.3969/j.issn.1674-4985.2021.33.010

跟骨骨折属于临床上比较多见的足部骨折类型，导致此类疾病发生的关键原因为高空坠落及交通事故等，其中发生率较高的损伤类型为SandersⅡ、Ⅲ型损伤[1]。若患者不能及时得到科学合理的救治，则会进一步引发创伤性关节炎及畸形愈合等多种严重并发症，并对患者的正常生活及生活质量造成不利影响[2]。……