摘要
目的比较微创与传统术式治疗SandersⅡ型跟骨关节内骨折的临床疗效。方法选择2011年6月至2014年6月玉林市第一人民医院收治的60例SandersⅡ型跟骨关节内骨折患者为研究对象,按照随机数字表法分为观察组和对照组,各30例。观察组给予微创内固定治疗,对照组给予传统"L"形切口内固定治疗。记录两组患者等待时间、手术时间、术后引流量、早期并发症、晚期并发症,测量术前、术后Bhler角、Gissane角,采用视觉模拟量表(VAS)、美国骨科足踝外科协会(AOFAS)后足评分及健康状况调查表(SF-36)对手术效果进行评估。结果观察组术后引流量少于对照组[(60±19)m L比(206±41)m L],早期并发症、晚期并发症发生率低于对照组[0.0%比13.3%(4/30);26.7%(8/30)比100.0%(30/30)],差异有统计学意义(P<0.05)。治疗后,观察组和对照组患者的Bhler角、Gissane角均高于治疗前[(27±5)比(14±4)、(116±19)比(88±11);(26±6)比(14±4)、(115±21)比(88±14)],差异有统计学意义(P<0.01)。治疗后,观察组和对照组患者的SF-36评分、AOFAS后足评分均高于治疗前[(80±12)分比(51±9)分、(90±16)分比(58±12)分;(71±10)分比(51±10)分、(84±13)分比(60±11)分],VAS评分低于治疗前[(1.8±0.5)分比(7.4±1.5)分,(2.0±0.6)分比(7.5±1.7)分],差异均有统计学意义(P<0.01);治疗后,观察组SF-36评分高于对照组(P<0.01)。结论微创内固定治疗SandersⅡ型跟骨骨折可以获得与传统内固定治疗接近的疗效,且对患者创伤小,早晚期并发症发生率较低,有利于患者距下关节功能的恢复,可加速患者的康复。
Objective To compare curative effect of minimally invasive and traditional surgical method treating SandersⅡ intra-articular calcaneal fractures. Methods Total of 60 cases of SandersⅡ intra-articular calcaneal fractures admitted to Yulin First People＇s Hospital from Jun. 2011 to Jun. 2014 were randomly divided into observation group and control group according to random number table method,30 cases in each group. The observation group was given minimally invasive internal fixation treatment; the control group was given the traditional ＂ L＂ shape incision fixation treatment. Waiting time,operation time,postoperative complications,early and late complications of thetwo groups were recorded,and the preoperative and postoperative Bohler angle,Gissane angle were measured,the visual analog scale（ VAS）,the American orthopedic foot and ankle surgery association（ AOFAS） hind score and health questionnaire（ SF-36） were used to evaluate the surgical effect. Results Postoperative drainage of the observation group was less than the control group[（ 60 ± 19） m L vs（ 206 ± 41） m L],early complications,late complication rate lower than the control group[0. 0% vs 13. 3%（ 4 /30）; 26. 7%（ 8 /30） vs 100. 0%（ 30 /30） ],the difference was statistically significant（ P 〈0. 05）. After treatment,B hler angle,Gissane angle of the observation group and the control group,were higher than before treatment[（ 27 ± 5） ° vs（ 14 ± 4） °,（ 116 ± 19） ° vs（ 88 ± 11） °;（ 26 ± 6） ° vs（ 14 ±4） °,（ 115 ± 21） ° vs（ 88 ± 14） ° ],the differences were statistically significant（ P 〈0. 01）. After treatment,the SF-36 scores,AOFAS hindfoot score were higher than before treatment [（ 80 ± 12） scores vs（ 51 ±9） scores,（ 90 ± 16） scores vs（ 58 ± 12） scores;（ 71 ± 10） scores vs（ 51 ± 10） scores,（ 84 ± 13）scores vs（ 60 ± 11） scores],VAS scores lower than before treatment [（ 1. 8 ± 0. 5） scores vs（ 7. 4 ±1. 5） scores;（ 2. 0 ± 0. 6） scores vs（ 7. 5 ± 1. 7） scores],the differences were statistically significant（ P 〈0. 01）; after treatment,the SF-36 score of the observation group was higher than the control group（ P 〈0. 01）. Conclusion Minimally invasive internal fixation treating Sanders Ⅱ calcaneal fractures can obtain the similar curative effect to the traditional internal fixation treatment,with less trauma to the patients,lower early and late complication rates,which is beneficial to the subtalar joint function recover,and can accelerate the recovery of the patients.
出处
《医学综述》
2016年第6期1212-1214,共3页
Medical Recapitulate
关键词
SandersⅡ型跟骨关节内骨折
微创治疗
疗效
关节功能
并发症
Sanders Ⅱ intra-articular calcaneal fractures
Minimally invasive treatment
Curative effect
Joint function
Complications
