两种不同切口治疗Sander II~III型跟骨骨折的临床疗效观察

Clinical Observation on the Therapeutic Effects of Two Different Incisions in the Treatment of Sander II~III Type Calcaneal Fractures

摘要: 目的：比较外侧“L”形切口与跗骨窦小切口，这两种不同切口方式对跟骨骨折的疗效分析。方法：本研究回顾性分析2018年6月至2021年6月在本院就我院开展的两种不同切口方式对跟骨骨折进行手术的患者。比较在术前、术后1月、术后3月VAS评分评估患肢疼痛分级，采用Mayfand评分评估患者术前、术后1月、术后3月踝关节功能。通过Bohler角、Gissane角评估跟骨骨折恢复角度。C反应蛋白及白介素-6比较患者炎症指标情况。结果：通过对两组患者进行比较，两组患者均获得完整随访，两组患者术后Bohler角、Gissane角较术前均明显改善，差异不具有统计学意义(P > 0.05)，两组患者术前、术后1月、术后3月VAS评分比较未见明显差异，差异不具有统计学意义(P > 0.05)，两组患者术后1月3月比较Mayfand评分具有统计学差异(P > 0.05)。两组患者C反应蛋白及白介素-6术后比较，具有统计学差异(P > 0.05)。结论：综上所述，跗骨窦小切口和外侧“L”形切口均可对Sander II~III型跟骨骨折患者达到较好的治疗效果。跗骨窦小切口可获得更好的功能以及更低的炎症情况。

Abstract: Objective: To compare the efficacy of two different incision approaches for calcaneal fracture between lateral “L” shaped incision and tarsal sinus mini-incision. Methods: This study retrospectively analysed patients who underwent surgery for calcaneal fracture from June 2018 to June 2021 in our hospital for the two different incision approaches performed in our hospital. Comparison of pain grading of the affected limb was assessed by VAS score preoperatively, at 1 month postoperatively and at 3 months postoperatively, and ankle function was assessed using Mayfand score in patients preoperatively, at 1 month postoperatively and at 3 months postoperatively. The angle of recovery of calcaneal fracture was assessed by Bohler’s angle and Gissane’s angle. C-reactive protein and interleukin-6 were compared with the inflammatory indexes of the patients. Results: By comparing the two groups of patients, both groups of patients received complete follow-up, the postoperative Bohler’s angle and Gissane’s angle of both groups were significantly improved compared with the preoperative period, and the difference was not statistically significant (P > 0.05), and the comparison of VAS scores of the two groups of patients in the preoperative period, 1 month after operation, and 3 months after operation did not show any significant difference, and the difference was not statistically significant (P > 0.05). Mayfand score was statistically different when comparing the two groups in January and March postoperatively (P > 0.05). C-reactive protein and interleukin-6 were statistically different when comparing the two groups of patients postoperatively (P > 0.05). Conclusion: In conclusion, both small tarsal sinus incision and lateral “L” shaped incision can achieve better treatment results for patients with Sander II~III calcaneal fracture. A small tarsal sinus incision results in better function and lower inflammation.