经跗骨窦微创切口治疗跟骨骨折的临床疗效分析

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经跗骨窦微创切口治疗跟骨骨折的临床疗效分析

作者：叶军 白龙 于志勇

来源：《中国现代医生》2017年第29期

[摘要] 目的 探讨经跗骨窦微创切口松质骨螺钉加自制小钢板内固定治疗跟骨骨折的临床疗效。 方法 将我科收治并需要手术治疗的跟骨骨折患者随机分为微创组和对照组，每组30例。骨折类型按 Sanders 分型标准。微创组患者采用经跗骨窦微创切口松质骨螺钉加自制小钢板内固定治疗（Ⅱ型 16 例、Ⅲ型 10 例、Ⅳ型 4 例）；对照组采用经传统“L”形切口复位钢板螺钉内固定治疗（Ⅱ型 14 例、Ⅲ型 9 例、Ⅳ型 7 例）。观察两种方法治疗前后患足功能的恢复情况，评定治疗的优良率。 结果 经 7～18个月随访，患者均获得骨性愈合。两种患者治疗后跟骨长度、宽度、高度、Bohler 角、Gissane 角及优良率比较，差异均无统计学意义（P>0.05）。微创组患者切口均甲级愈合，对照组有5例出现伤口延迟愈合，经伤口换药后约4～8周伤口愈合。 结论 经跗骨窦微创切口松质骨螺钉加自制小钢板内固定治疗跟骨骨折具有创伤小、术后固定可靠，软组织并发症少等优点，是治疗跟骨骨折的良好选择。 [关键词] 跗骨窦切口；微创治疗；跟骨骨折；内固定

[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2017）29-0067-03

Analysis on the clinical effect of minimally invasive incision via tarsal sinus in the treatment of calcaneal fractures

YE Jun BAI Long YU Zhiyong

Department of Orthopedics， Fuyong People’s Hospital in Bao’an District of Shenzhen City， Shenzhen 518103，China

[Abstract] Objective To investigate the clinical effect of minimally invasive incision via the tarsal sinus with cancellous bone screw and self-made small plate internal fixation in the treatment of calcaneal fractures. Methods The patients with calcaneal fractures who were admitted and treated in our department and were in need of surgery were randomly divided into two groups： minimally invasive group and control group， with 30 cases in each group. The types of fractures were according to Sanders classification. The patients in the minimally invasive group were given

minimally invasive incision via tarsal sinus with cancellous bone screw and self-made small plate internal fixation（Type Ⅱ 16 cases， type Ⅲ 10 cases， type Ⅳ 4 cases）； the control group was given traditional \（type Ⅱ 14 cases， type Ⅲ 9 cases， type Ⅳ 7 cases）. The recovery of affected feet before and after the treatment by the two methods were observed. The excellent and good rate of the treatment was evaluated. Results After 7

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