目的:分析外侧横弧形切口和扩大L形切口切开复位内固定手术治疗粉碎性跟骨骨折的临床效果。方法:回顾性选取2019年9月—2022年12月杭州师范大学附属医院收治的102例粉碎性跟骨骨折患者。根据患者手术入路的不同将其分为观察组(59例)和对照组(43例)。对照组给予外侧横弧形切口切开复位内固定手术。观察组给予扩大L形切口切开复位内固定手术。比较两组围手术期指标、并发症、切口愈合情况、相关指标。结果:观察组手术时间及切口愈合时间、切口长度均长于对照组，手术失血量多于对照组，差异有统计学意义(P<0。05)。两组术后并发症发生率比较，差异无统计学意义(P>0。05)。两组切口愈合情况比较，差异无统计学意义(P>0。05)。术后1个月、10个月，观察组Barthel指数、美国足踝外科协会踝与后足功能(American Orthopaedic Foot and Ankle Society，AOFAS)评分均高于对照组;术后1个月，观察组视觉模拟评分法(visual analogue scale，VAS)评分高于对照组，术后10个月，VAS评分低于对照组;术后10个月观察组复位率高于对照组，差异有统计学意义(P<0。05)。结论:粉碎性跟骨骨折行切口复位内固定手术治疗中，扩大L形切口手术损伤相对高于外侧横弧形切口，但是并未增加安全性风险，且复位效果与恢复结果更佳。
Clinical Effect of Lateral Transverse Arc Incision and Extended L-shaped Incision with Open Reduction and Internal Fixation Surgery in the Treatment of Pulverizability Calcaneal Fracture
Objective:To analyze the clinical effect of lateral transverse arc incision and extended L-shaped incision with open reduction and internal fixation surgery in the treatment of pulverizability calcaneal fracture.Method:A total of 102 patients with pulverizability calcaneal fracture admitted to the Hangzhou Normal University Affiliated Hospital from September 2019 to December 2022 were retrospectively selected.The patients were divided into observation group (59 cases) and control group (43 cases) according to the different surgical approaches.The control group received open reduction and internal fixation with lateral transverse arc incision.The observation group was given extended L-shaped incision with open reduction and internal fixation.Perioperative indexes,complications,wound healing and related indexes were compared between the two groups.Result:The operative time,incision healing time and incision length in the observation group were longer than those in the control group,and the operative blood loss was higher than that in the control group,the differences were statistically significant (P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05).There was no significant difference in incision healing between the two groups (P>0.05).At 1 month and 10 months after surgery,Barthel index and American Orthopaedic Foot and Ankle Society (AOFAS) scores in the observation group were higher than those in the control group,visual analogue scale (VAS) scores of the observation group was higher than that of control group 1 month after surgery,and VAS score was lower than that of the control group 10 months after surgery,the reduction rate in the observation group was higher than that in the control group 10 months after surgery,and the differences were statistically significant (P<0.05).Conclusion:During open reduction and internal fixation surgery of pulverizability calcaneal fracture,the extended L-shaped incision has relatively higher surgical damage than the lateral transverse arc incision,but it does not increase the safety risk,and the final reduction effect and recovery results are better.
万方数据
维普
