经跗骨窦切口治疗跟骨关节内骨折54例临床效果分析

目的探讨跟骨关节内骨折患者应用跗骨窦切口进行切开复位钢板固定的临床效果。方法回顾性分析2013-2015年收治的54例跟骨关节内骨折患者临床资料,其中男性40例,女性14例;年龄22~56岁,平均42.3岁。致伤原因:高处坠落伤32例、道路交通伤18例,其他4例。患者累及距下关节跟骨骨折,对其进行经跗骨窦切口入路跟骨解剖钢板方法进行内固定治疗,如有必要则进行植骨手术,评价经跗骨窦微创切口跟骨解剖钢板治疗的临床效果。结果 X线片显示患者解剖结构恢复良好。Bohlee角平均恢复到38°,Gissane角平均恢复到135°。术后对其进行平均12个月的随访,其中46例获得随访,对其临床治疗效果以Maryland足部评分系统进行评价,患者临床治疗总有效率为86.9%。结论对跟骨关节内骨折患者应用经跗骨窦切口入路外侧跟骨钢板内固定方法进行治疗,必要时联用植骨方法,能够获得良好的临床治疗效果,且患者接受治疗后不会出现严重的不良反应,具有安全高效的优点,值得临床推广。

Clinical analysis on the curative effect of tarsal sinus incision for the treatment of 54 cases of intra-articular calcaneal fractures

Objective To investigate the clinical efficacy of tibial sinus incision in patients with intra-articular calcaneal fractures. Methods Clinical data of the 54 patients with intra-articular calcaneal fractures,who received regular treatment in our hospital during 2013 to 2015 was analyzed retrospectively.There were 40 males and 14 females, aged 22 to 56 (average age, 42.3).There were 32 cases of high-falling injury, 18 cases of traffic injury, and 4 cases of other causes.For those calcaneal fractures with involvement of joint, calcaneal plate fixation was applied via tarsal sinus incision, with bone grafting when necessary.Then the therapeutic effect of locking plate fixation with tarsal sinus incision was evaluated. Results X-ray confirmed a satisfactory degree of anatomy structure.Bohler angle and Gissane's angle, had been corrected to on average of 38 degrees and 135 degrees, respectively.Forty-six cases were followed-up for 12 months in average.Maryland foot score system was adopted to measure the therapeutic efficacy.And the total effective rate was 86.9%. Conclusion The application of tarsal sinus incision approach and lateral calcaneal plate fixation, with additional bone grafting if necessary, for those with intra-articular calcaneal fractures can gain satisfactory outcome without adverse reaction.It can be regarded as a safe and effective treatment, thus it is worthy of clinical promotion.