摘要
目的比较采用扩大外侧入路(ELA)和经跗骨窦间隙微创入路(STA)跟骨关节内骨折内固定术后12个月的足底压力步态情况。方法选取2015年1月—2018年11月我院收治的34例跟骨关节内骨折患者,根据患者意愿选择ELA入路手术(ELA组)18例和STA入路手术(STA组)16例。术后12个月于门诊行足底压力步态分析,比较两组患侧与健侧足底压力相关参数的差异。结果STA组患侧和健侧前足区压力中心(COP)时间百分比比较差异有统计学意义(P<0.05),而两侧足地接触时间、足跟与地面接触时间、全足压力峰值与体质量比值、足跟压力峰值与体质量比值、COP移动最大速度、COP移动平均速度及足跟区、中足区、足趾区COP时间百分比比较差异均无统计学意义(P>0.05)。而ELA组上述足底压力相关参数患侧和健侧比较差异均有统计学意义(P<0.05或P<0.01)。结论相比ELA入路,STA入路跟骨关节内骨折内固定术后早期患侧足底压力与健侧更为接近,双足更对称,接近正常步态。对于跟骨移位关节内骨折手术治疗建议采用STA入路。
Objective To compare the gait results of plantar pressure 12 months after internal fixation of calcaneal fracture through extended lateral approach(ELA)and minimally invasive approach through sinus tarsal space(STA).Methods During January 2015 and November 2018,34 patients with intra-articular calcaneal fractures were randomly treated with ELA(n=18)and STA(n=16)according to patient's intention.The plantar pressure analysis was performed in the outpatient department to compare the differences of the parameters related to plantar pressure between two sides at 12 months postoperatively.Results In STA group the difference between two sides in percentage of time of center of pressure(COP)in the front feet area was statistically significant(P<0.05).There was no significant difference in the time of heel-contact with the ground,the ratio of the whole foot pressure to body mass index(BMI),ratio of peak plantar pressure to BMI,the maximum velocity of COP,the average speed of COP and percentage of COP time in heel area,the midfoot area,and toe area between two sides(P>0.05).The above parameters related to foot pressure in ELA group showed statistically significant differences between two sides(P<0.05 or P<0.01).Conclusion Compared with those with the ELA,the plantar pressure in the affected side is similar to the unaffected side in patients with STA in the early stage.Namely,the feet status is more symmetrical and close to the normal gait.Therefore,STA is recommended for surgical treatment of displaced calcaneal fractures.
作者
刘丽丹
吕宪玉
郭英飞
李嘉琦
王凌云
LIU Li-dan;LYU Xian-yu;GUO Ying-fei;LI Jia-qi;WANG Ling-yun(The Third Outpatient Department of Logistics Support Forces,Beijing 100039,China;Outpatient Department of Air Force Command,Beijing 100038,China;Department of Orthopedics,980 Hospital of PLA Joint Logistics Support Forces,Shijiazhuang 050082,China)
出处
《临床误诊误治》
2020年第12期65-69,共5页
Clinical Misdiagnosis & Mistherapy
基金
河北省医学科学研究课题(20200249)。
关键词
关节内骨折
跟骨
骨折固定术
扩大外侧入路
经跗骨窦间隙微创入路
足底压力
Intra-articular fractures
Calcaneus
Fracture fixation,internal
Extended lateral approach
Minimally invasive approach through tarsal sinus space
Plantar pressure
