| 陶宝琛,范洪伟,原玉海,赵 军,王利胜.跗骨窦切口与外侧L形切口钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折的疗效比较及对术后足部功能和血清应激因子的影响[J].,2023,(3):515-518 |
| 跗骨窦切口与外侧L形切口钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折的疗效比较及对术后足部功能和血清应激因子的影响 |
| Comparison of Efficacy between Tarsal Sinus Incision and Lateral L-Shaped Incision Plate Internal Fixation in the Treatment of Sanders Ⅱ and Ⅲ Type Calcaneal Fractures and its Effect on Postoperative Foot Function and Serum Stress Factors |
| 投稿时间：2022-05-10 修订日期：2022-05-30 |
| DOI：10.13241/j.cnki.pmb.2023.03.023 |
| 中文关键词: 外侧L形切口 跗骨窦切口 钢板内固定 跟骨骨折 疗效 足部功能 应激因子 |
| 英文关键词: External L-shaped incision Tarsal sinus incision Plate internal fixation Calcaneal fractures Efficacy Foot function Stress factors |
| 基金项目:陕西省科学技术厅科技计划项目（2022SF330） |
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| 中文摘要: |
| 摘要 目的：对比外侧L形切口与跗骨窦切口钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折的疗效，并分析两种手术方式对术后足部功能和血清应激因子的影响。方法：选择2014年1月-2021年1月期间来我院接受治疗的SandersⅡ、Ⅲ型跟骨骨折100例患者，根据手术方式的不同将患者分为A组（外侧L形切口钢板内固定，n=49）和B组（跗骨窦切口钢板内固定，n=51），对比两组围术期指标、术后足部功能和血清应激因子变化情况，记录两组并发症发生情况。结果：B组的手术时间、切口长度、住院天数较A组短，术后引流量较A组少（P<0.05），两组骨折愈合时间组间对比未见差异（P>0.05）。两组术后6个月Bohler角、Gissane角均扩大（P<0.05）。两组术后6个月视觉模拟评分法（VAS）评分下降，Maryland足功能评分升高（P<0.05）。两组术后7 d皮质醇（Cor）、肾上腺素（E）水平升高（P<0.05），B组术后7 d Cor、E水平低于A组（P<0.05）。B组的并发症发生率小于A组（P<0.05）。结论：与外侧L形切口钢板内固定治疗相比，经跗骨窦切口治疗SandersⅡ、Ⅲ型跟骨骨折，应激程度轻，创伤小，术后足部功能恢复快，并发症发生率低。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the efficacy of lateral L-shaped incision and tarsal sinus incision plate internal fixation in the treatment of Sanders Ⅱ and Ⅲ type calcaneal fractures, and to analyze the effects of the two surgical methods on postoperative foot function and serum stress factors. Methods: 100 cases of patients with Sanders II and III type calcaneal fractures who were treated in our hospital from January 2014 to January 2021 were selected. Patients were divided into group A (lateral L-shaped incision plate internal fixation, n=49) and group B (tarsal sinus incision plate internal fixation, n=51) according to the different surgical methods. The perioperative indexes, postoperative foot function and serum stress factors of the two groups were compared, and the complications of the two groups were recorded. Results: The operation time, incision length and hospital stay in group B were shorter than those in group A, and the postoperative drainage volume was less than that in group A(P<0.05). There was no difference in fracture healing time between the two groups (P>0.05). Bohler Angle and Gissane Angle were enlarged at 6 months after operation in both groups (P<0.05). At 6 months after operation, the visual analogue scale (VAS) score decreased, and the Maryland foot function score increased in the two groups (P<0.05). The levels of cortisol (Cor) and epinephrine (E) in the two groups at 7 d after operation increased (P<0.05), and the levels of Cor and E in group B were lower than those in group A at 7 d after operation(P<0.05). The complication rate in group B was lower than that in group A(P<0.05). Conclusion: Compared with lateral L-shaped incision plate internal fixation, transtarsal sinus incision for Sanders Ⅱ and Ⅱ type calcaneal fractures has less stress, less trauma, the foot function recovered quickly after operation, and lower incidence of complications. |
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