小切口微创治疗Sanders Ⅱ型、Ⅲ型跟骨骨折的疗效分析

目的探讨应用小切口微创结合撬拨复位治疗Sanders Ⅱ型、Ⅲ型跟骨骨折的方法及疗效。 方法回顾性收集保定市第一中心医院2015年1月至2017年8月收治的跟骨骨折患者30例，分型为Sanders Ⅱ型12例、Ⅲ型18例，所有患者采用跟骨外侧小切口微创结合撬拨复位治疗。男性24例，女性6例。年龄22~64岁，平均年龄为（36±11）岁。所有患者均为新鲜闭合骨折，其中左侧12例，右侧18例。伤后至手术时间3~10 d，平均（5.0±1.2）d。术后随访观察患足功能及并发症情况，并比较手术前后Bohler角、Gissane角、跟骨高度及宽度。 结果所以患者均获得满意随访，平均随访（10.0±2.9）个月。Maryland足功能评分显示该方法治疗跟骨骨折优良率为90.0%。Bohler角术前为（10±4）°、术后（30±5）°，Gissane角术前（91±5）°、术后（121±10）°，术前术后比较，差异均有统计学意义（t=-15.59，t=-17.62，均P<0.05）。所有患者术后均无切口边缘皮肤坏死、血肿、明显的骨折再移位、腓骨肌腱炎等并发症。 结论小切口微创治疗Sanders Ⅱ型、Ⅲ型跟骨骨折疗效满意，并发症少，可早期手术治疗，无需等待肿胀完全消退后在手术治疗，值得临床推广。

Effect for treatment of Sanders II and III calcaneal fractures with minimally invasive incision

ObjectiveTo investigate the effect of Sanders Ⅱ and Ⅲ calcaneal fractures with minimally invasive incision combined with percutaneous reduction. MethodsThirty patients with calcaneal fractures from January 2015 to August 2017 in the First Central Hospital of Baoding City were retrospectively reviewed. The classification was 12 cases of Sanders type Ⅱ and 18 cases of type Ⅲ. All patients underwent small incision of the lateral calcaneus. Invasive combined with the reduction of treatment. There were 24 males and 6 females. The age ranged from 22 to 64 years old and the average age was (36±11) years. All patients were fresh closed fractures, including 12 on the left and 18 on the right. The time from injury to surgery was 3 to 10 days, with an average of (5.0±1.2) days. Postoperative follow-up was performed to observe the function and complications of the foot, the Bohler angle, the Gissane angle, the height and width of the calcaneus before and after the operation were compared. ResultsAll patients were followed up satisfactorily, with an average follow-up of (10.0±2.9) months. The Maryland foot function score showed that the excellent rate of this method for the treatment of calcaneal fracture was 90.0%. Preoperative and postoperative Bohler angle were (10±4)° and (30±5)°, preoperative and postoperative of Gissane angle (91±5)° and (121±10)°, the comparison was statistical significance (t=-15.59, t=-17.62, both P<0.05). All patients had no complications such as skin necrosis, hematoma, obvious fracture, displacement and iliac tendonitis. ConclusionsThe treatment of minimally invasive minimally invasive of Sanders type Ⅱ and Ⅲ calcaneal fractures is satisfactory, with few complications, and can early operated. It is worthy of clinical promotion without waiting for the swelling to completely resolve after surgery.