摘要
目的 探讨踝关节镜辅助下经跗骨窦入路内固定治疗Sanders Ⅱ、Ⅲ型跟骨骨折的疗效.方法 采用踝关节镜辅助下经跗骨窦入路内固定治疗23 例跟骨骨折患者.记录骨折愈合情况、Böhler角、Gissane角、跟骨高度及宽度、踝关节活动度、术后并发症发生情况,采用AOFAS踝-后足评分评价踝关节功能.结果 患者均获得随访,时间10～16 个月.切口均一期愈合,未发生切口感染或坏死、骨折不愈合等并发症.术后10～12 周骨折线均模糊,骨痂形成,骨折愈合.Böhler角、Gissane角、跟骨高度及宽度术后6 个月均较术前改善(P<0.05).末次随访时,患者均能完全负重行走,步态正常;踝关节背伸 15°～25°,跖屈 30°～45°;采用AOFAS踝-后足评分评价功能:优17 例,良5 例,可1 例,优良率22/23.结论 踝关节镜辅助下经跗骨窦入路内固定治疗Sanders Ⅱ、Ⅲ型跟骨骨折,骨折复位精准,术中透视次数少、创伤小,术后足部功能恢复满意、并发症发生率低.
Abstract
Objective To investigate the effect of transtarsal sinus approach internal fixation assisted by ankle arthros-copy on Sanders tppeⅡ,Ⅲcalcaneal fractures.Methods The 23 patients with calcaneal fractures were treated with transtarsal sinus approach internal fixation assisted by ankle arthroscopy.Fracture healing,Böhler angle,Gissane an-gle,calcaneal height and width,ankle motion range and postoperative complications were recorded.AOFAS ankle-hindfoot score was used to evaluate the ankle function.Results All patients were followed up for 10～16 months.All incisions healed in one-stage,without skin infection,necrosis and nonunion.At 10～12 weeks postoperation,all frac-ture lines were blurred,callus formed and fracture healing were obtained.Böhler angles,Gissane angles,calcaneal height and width were improved at postoperative 6 months,compared with the preoperation(P<0.05).At the last fol-low-up,all patients could walk completely and their gaits were normal.Dorsiflexion of ankle joint was 15°～25°,plan-tar flexion was 30°～45°;AOFAS ankle-hindfoot score was used to evaluate the function:excellent 17 cases,good 5 cases,fair 1 case,with an excellent-good rate of 22/23.Conclusions Ankle arthroscopy-assisted internal fixation treatment of Sanders type Ⅱ,Ⅲ calcaneal fractures with transtarsal sinus approach has accurate fracture reduction,with fewer intraoperative fluoroscopy and less trauma,satisfactory recovery of postoperative foot function and lower in-cidence rate of complications.
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