微创螺钉固定术与切开复位钢板内固定术对跟骨骨折患者的治疗效果比较OA
Comparison of the Therapeutic Effects of Minimally Invasive Screw Fixation and Open Reduction and Plate Internal Fixation on Patients with Calcaneal Fractures
目的:比较微创螺钉固定术与切开复位钢板内固定术对跟骨骨折患者的治疗效果.方法:回顾性分析2022年 1月—2023年 12月通辽市人民医院收治的 82例跟骨骨折患者临床资料,依照治疗方式的不同将其分为微创组和切开复位组,各 41例.微创组采取微创螺钉固定术治疗,切开复位组采取切开复位钢板内固定术治疗.比较两组手术安全性指标、临床指标、足踝功能及并发症发生情况.结果:两组术中X线暴露时间比较,差异无统计学意义(P>0.05);微创组手术时间短于切开复位组,术中出血量少于切开复位组,差异均有统计学意义(P<0.05).术后 2 d,两组跟骨高度、跟骨长度、Bohler角均大于术前,跟骨宽度、Gissane角均小于术前,差异均有统计学意义(P<0.05);但两组间比较,差异均无统计学意义(P>0.05).术后 3个月、1 年,两组美国足踝外科医师协会(AOFAS)评分均高于术前,差异均有统计学意义(P<0.05);术后 3个月,两组AOFAS评分比较,差异无统计学意义(P>0.05);术后 1年,微创组AOFAS评分高于切开复位组,差异有统计学意义(P<0.05).微创组并发症发生率为4.88%,低于切开复位组的19.51%,差异有统计学意义(P<0.05).结论:微创螺钉固定术与切开复位钢板内固定术均具有良好疗效,但微创螺钉固定术术中出血量少,手术时间短.尽管两种术式均可恢复跟骨解剖结构,但微创螺钉固定术在远期功能恢复和降低并发症发生率上表现更优.
Objective:To compare the therapeutic effects of minimally invasive screw fixation and open reduction plate internal fixation on patients with calcaneal fractures.Methods:A retrospective analysis was conducted on the clinical data of 82 patients with calcaneal fractures admitted to Tongliao People's Hospital from January 2022 to December 2023.They were divided into a minimally invasive group and an open reduction group according to the different treatment methods,with 41 cases in each group.The minimally invasive group was treated with minimally invasive screw fixation,while the open reduction group was treated with open reduction and plate internal fixation.The clinical indicators of surgical safety,foot and ankle functions and the occurrence of complications were compared between the two groups.Results:There was no statistically significant difference in the intraoperative X-ray exposure time between the two groups(P>0.05).The operation time of the minimally invasive group was shorter than that of the open reduction group,and the intraoperative blood loss was less than that of the open reduction group,the differences were statistically significant(P<0.05).Two days after the operation,the calcaneal height,calcaneal length and Bohler Angle in both groups were larger than those before the operation,while the calcaneal width and Gissane Angle were smaller than those before the operation,the differences were statistically significant(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).At 3 months and 1 year after the operation,the American Orthopaedic Foot and Ankle Society(AOFAS)scores of both groups were higher than those before the operation,the differences were statistically significant(P<0.05).Three months after the operation,there was no statistically significant difference in the AOFAS score between the two groups(P>0.05).One year after the operation,the AOFAS score of the minimally invasive group was higher than that of the open reduction group,the difference was statistically significant(P<0.05).The incidence of complications in the minimally invasive group was 4.88%,which was lower than 19.51%in the open reduction group,the difference was statistically significant(P<0.05).Conclusion:Both minimally invasive screw fixation and open reduction plate internal fixation have good therapeutic effects.However,minimally invasive screw fixation has less intraoperative blood loss and a shorter operation time.Although both surgical methods can restore the calcaneal anatomical structure,minimally invasive screw fixation performs better in long-term functional recovery and reducing the incidence of complications.
张炀
内蒙古自治区通辽市人民医院手足踝外科,内蒙古自治区 通辽 028000
医药卫生
跟骨骨折微创螺钉固定术切开复位钢板内固定术足踝功能
Calcaneal fractureMinimally invasive screw fixationOpen reduction and plate internal fixationFoot and ankle functions
《中国伤残医学》 2025 (8)
10-14,5
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