经皮闭合复位有限切开微创钢板内固定治疗跟骨骨折疗效分析

目的比较经皮闭合复位有限切开微创钢板内固定(MIPPO)与传统L形切口切开复位钢板内固定(ORIF)治疗SandersⅡ~Ⅳ型闭合性跟骨骨折的临床疗效。方法笔者自2013-06—2015-06分别采用经皮闭合复位有限切开MIPPO技术(试验组)和传统L形切口ORIF(对照组)治疗64例SandersⅡ~Ⅳ型闭合性跟骨骨折,比较2组术后AOFAS评分、术前及术后Bohler角、切口长度、术中出血量、手术时间、切口愈合情况、术后并发症发生率及住院时间。结果2组术后获得随访12~36(21.3±8.8)个月。2组术后12个月AOFAS评分优良率比较差异无统计学意义(P0.05)。2组术后7 d Bohler角明显高于术前,差异有统计学意义(P0.05)。试验组切口长度、术中出血量、手术时间、住院时间、切口愈合情况及并发症发生率明显优于对照组,差异有统计学意义(P0.05)。结论经皮闭合复位有限切开MIPPO技术治疗SandersⅡ~Ⅳ型单侧跟骨骨折取得满意的临床疗效,具有损伤更小、愈合更快、并发症发生率低等优势,值得临床推广。

Minimally invasive percutaneous reduction and a locking plate for treatment of calcaneal fractures

Objective To compare the clinical effect of minimally invasive percutaneous reduction and a locking plate(MIPPO) with the traditional opened reduction and L-shaped internal plate fixation (ORIF) for treatment of Sanders type Ⅱ-Ⅳ unilateral calcaneal fractures.Methods A total of 64 cases of Sanders type Ⅱ-Ⅳ closed calcaneal fractures were treated with MIPPO technique (the experimental group) and traditional ORIF technique (the control group) from June 2013 to June 2015.Postoperative AOFAS scores,preoperative and postoperative Bohler angle,length of incision,blood loss,operative time,wound healing,the incidence of postoperative complications and hospital stay of the two groups were recorded and compared.Results The average follow-up was 21.3±8.8 (12-36)months after operation.There was no significant difference in the AOFAS score between the two groups at 12 months(P ＞0.05).The Bohler angle at 7 days after operation of the two groups was significantly higher than that before operation (P ＜0.05).Incision length,blood loss,operative time,wound healing,the incidence of complication and hospital stay of the test group were significantly better than the control group,the differences were statistically significant (P ＜0.05).Conclusion Minimally invasive percutaneous reduction and a locking plate for treatment of Sanders type Ⅱ-Ⅳ unilateral calcaneal fractures can obtain satisfactory clinical efficiency,and this surgical method should be promoted with less damage,faster healing,low incidence of complication and other advantages.