不同入路内固定在老年Sanders Ⅲ型跟骨骨折中的应用及对骨折复位、疼痛介质的影响
Application of different approaches to internal fixation in elderly patients with Sanders type Ⅲ calcaneal fracture and its influence on fracture reduction and pain mediators
张云峰 1时晓雨 1王广吉 1王欣1
作者信息
- 1. 南阳油田总医院创伤骨科,河南南阳 473000
- 折叠
摘要
目的 对比不同入路内固定在老年Sanders Ⅲ型跟骨骨折中的应用及对患者骨折复位、疼痛介质的影响.方法 选取2019年3月-2022年9月确诊的老年Sanders Ⅲ型跟骨骨折患者80例,依据随机数字表法分成跗骨窦组、传统组,各40例.其中传统组行L形切口入路钢板内固定,跗骨窦组行跗骨窦"八"字切口入路钢板内固定.对比两组围术期指标、并发症状况、跟骨恢复效果以及围术期疼痛介质[P物质(SP)、前列腺素E2(PGE2)、5-羟色胺(5-HT)]、骨折复位状况(跟骨高度、Bohler角、Gissane角).结果 跗骨窦组住院时间与术中出血量均少于传统组(P＜0.05);术后6个月,跗骨窦组、传统组跟骨恢复效果对比,差异无统计学意义(P＞0.05);两组术后3个月、6个月跟骨高度、Bohler角、Gissane角均高于术前(P＜0.05);跗骨窦组术后24h、72h血清SP、PGE2、5-HT水平均低于传统组(P＜0.05);跗骨窦组并发症发生率明显低于传统组(P＜0.05).结论 跗骨窦"八"字切口入路钢板内固定治疗老年Sanders Ⅲ型跟骨骨折,可促进跟骨功能恢复,缓解术后疼痛,减少并发症发生.
Abstract
Objective To compare the application of different approaches of internal fixation in elderly patients with Sanders type Ⅲ calcaneal fracture and its effects on fracture reduction and pain mediators.Methods A total of 80 elderly patients with Sanders type Ⅲ calcaneal fracture diagnosed in our hospital during 2019.3-2022.9 were selected and divided into tarsal sinus group and traditional group with 40 cases in each one according to random number table method.Among them,the traditional group underwent L incision approach plate internal fixation,and the tarsal sinus group underwent eight incision approach plate internal fixation.Perioperative indexes,complications,calcaneus recovery effect,perioperative pain mediators[Substance P(SP),prostaglandin E2(PGE2),5-hydroxyserotonin(5-HT)]and fracture reduction status(Calcaneus height,Bohler Angle,Gissane Angle)were compared between two groups.Results The length of hospital stay and intraoperative blood loss in tarsal sinus group were lower than those in traditional group(P＜0.05).Six months after operation,there was no significant difference in calcaneal recovery between tarsal sinus group and traditional group(P＞0.05).Calcaneus height,Bohler Angle and Gissane Angle at 3 and 6 months after operation were higher than those before operation(P＜0.05).Serum SP,PGE2 and 5-HT levels in tarsal sinus group were lower than those in traditional group 24h and 72h after operation(P＜0.05).The complication rate of tarsal sinus group was significantly lower than that of traditional group(P＜0.05).Conclusion The treatment of senile Sanders Ⅲ calcaneal fracture with"eight"incision in tarsal sinus can promote the recovery of calcaneal function,relieve postoperative pain and reduce complications.
关键词
L形切口入路/跗骨窦"八"字切口入路/钢板内固定/跟骨骨折Key words
Lincision approach/Sinus tarsi eight incision approach/Plate internal fixation/Calcaneal fracture引用本文复制引用
出版年
2024
NETL
NSTL
万方数据