黄朝荣 欧德阳 陈伟豪 黄政 莫建壕 邹镜宜

【摘要】 目的：探究改良跗骨竇切口解剖型锁定钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折临床效果及足功能恢复情况。方法：选取2017年1月-2019年1月本院收治的40例（40足）SandersⅡ、Ⅲ型跟骨骨折患者，根据随机数表法将其分为A组和B组，每组20例。A组采用改良跗骨窦切口解剖型锁定钢板内固定治疗，B组采用外侧“L”形切口内固定术治疗。比较两组临床指标、并发症发生情况及足功能恢复情况。结果：A组手术用时、切口长度均短于B组，术中出血量少于B组，差异均有统计出学意义（P<0.05）。两组近期并发症发生率比较，差异无统计学意义（P>0.05）。A组远期并发症发生率低于B组，差异有统计学意义（P<0.05）。A组足功能恢复优良率高于B组，差异有统计学意义（P<0.05）。结论：改良跗骨窦切口解剖型锁定钢板内固定治疗的手术用时少、创伤性小、安全性高、骨折愈合时间短，且可促进足功能恢复。

【关键词】 跟骨骨折 SandersⅡ、Ⅲ型 改良跗骨窦切口解剖型锁定钢板内固定 足功能恢复

Clinical Effect of Modified Sinus Tarsal Incision and Anatomical Locking Plate Internal Fixation in the Treatment of Sanders Ⅱ， Ⅲ Calcaneal Fractures and Analysis of Foot Function Recovery/HUANG Zhaorong， OU Deyang， CHEN Weihao， HUANG Zheng， MO Jianhao， ZOU Jingyi. //Medical Innovation of China， 2021， 18（24）： -173

[Abstract] Objective： To explore the clinical effect of modified sinus tarsal incision and anatomical locking plate internal fixation in the treatment of Sanders Ⅱ， Ⅲ calcaneal fractures and analysis of the foot function recovery. Method： A total of 40 patients （40 feet） with calcaneal fractures of Sanders Ⅱ， Ⅲ type in our hospital from January 2017 to January 2019 were selected， and they were divided into group A and group B according to the random number table method， 20 patients in each group. Group A was treated with modified sinus tarsal incision and anatomical locking plate internal fixation， group B was treated with external “L” incision internal fixation. The clinical indexes， incidence of complications and recovery of foot function recovery were compared between two groups. Result： The operation time and incision length of group A were shorter than those of group B， and the blood loss during operation of group A was less than that of group B， the differences were statistically significant （P<0.05）. There was no significant difference in the incidence of recent complications between two groups （P>0.05）. The incidence of long-term complications of the group A was lower than that of the group B， the difference was statistically significant （P<0.05）. The total excellent and good rate of foot function recovery of the group A was higher than that of the group B， the difference was statistically significant （P<0.05）. Conclusion： The modified sinus tarsal incision and anatomical locking plate internal fixation has less operation time， less trauma， high safety， short fracture healing time， and can promote the foot function recovery.

[Key words] Calcaneal fractures Sanders Ⅱ， Ⅲ Modified sinus tarsal incision and anatomical locking plate internal fixation Foot function recovery

First-author’s address： Zhaoqing First People’s Hospital， Zhaoqing 526060， China

doi：10.3969/j.issn.1674-4985.2021.24.042

跟骨骨折是最常见的一种跗骨骨折，在全身骨折中占比约为2.1%，跟骨骨折大都是由暴力撞击以及高空坠落等损伤所致[1]。由于跟骨解剖结构比较复杂，在SandersⅡ、Ⅲ型骨折患者中，均有两到三处骨折移位存在，且Ⅲ型骨折还存在一块塌陷骨折块，增加复位难度[2]。以往主要经“L”形切口内固定术对SandersⅡ、Ⅲ型跟骨骨折患者进行治疗，使骨折部位以及关节面充分暴露，术野清晰、广阔，术者在直视下就能进行完整的固定，但手术切口大，患者术后易发生切口感染、愈合延迟、皮瓣坏死等并发症，致使其应用受限[3]。……