经跗骨窦切口入路跟腓韧带处理对跟骨骨折术后功能影响的临床研究OA

Objective:To explore the impact of intraoperative calcaneofibular ligament(CFL)repair on the medium and long-term functional recovery in patients with the treatment of calcaneal fractures via the tarsal sinus incision approach.Methods:A retrospective analysis was conducted on the clini-cal data of 60 patients with Sanders type Ⅱ/Ⅲ calcaneal fractures who were admitted between January 2022 and December 2023.All patients were treated with surgery via the tarsal sinus incision approach.According to whether the calcaneofibular ligament was repaired during the operation,the patients were divided into the CFL repair group(n=30)and the CFL non-repair group(n=30).The operation time,intraoperative blood loss,fracture healing time,and quality of fracture reduction were compared between the two patient groups.All patients were followed up for at least 12 months after the operation.The functional recovery was evaluated using the American orthopaedic foot&ankle society(AOFAS)ankle-hindfoot score and the Maryland foot score.The degree of pain was evaluated by the visual analogue scale(VAS).The incidence of adverse events-including incision-related complications,subjective ankle instability,and early imaging findings suggestive of subtalar arthritis-was also recorded.Results:The operative time of the CFL non-repair group was(53.29±11.37)min,which was significantly shorter than that of the CFL repair group(68.73±10.35)min,and the difference was statistically significant(P<0.05).However,there was no significant difference in intraoperative blood loss between the two groups(P>0.05).All patients achieved bony union of fractures.There was no significant difference in fracture healing time or fracture reduction quality between the two groups(P>0.05).At 12 months after the operation,the AOFAS scores of the CFL repair group(89.53±6.22)points were significantly higher than that of the CFL non-repair group(82.31±7.54)points.The Maryland scores of the CFL repair group(90.07±4.81)points were also significantly higher than that of the CFL non-repair group(83.62±5.47)points.The VAS scores of the CFL repair group were(1.34±0.72)points,which were significantly lower than that of the CFL non-repair group(2.14±0.93)points,and the difference was statistically significant(P<0.05).In addition,the incidence of subjective ankle instability in the CFL repair group was 3.3%,and that in the CFL non-repair group was 20.0%.There was a statistically significant difference between the two groups(P<0.05).There was no significant difference between the two groups in terms of in-cision-related complications and early imaging findings of subtalar arthritis.Conclusion:When treating calcaneal fractures through the tarsal sinus incision approach,although the repair of the calcaneal peroneal ligament slightly prolongs the operation time,it can significantly improve the medium-and long-term functional scores,reduces pain,and effectively lowers the risk of postoperative ankle instability,thereby achieving better clinical efficacy.