CAJ | 학술논문

目的：探讨纵行切口和跗骨窦微创入路在跟骨关节内骨折治疗中的临床疗效。方法回顾性分析2008年3月至2012年3月我院收治的67例纵行切口或跗骨窦微创入路术治疗并跟踪随访的跟骨关节内骨折患者的临床资料,按照手术类型分为2组：纵行切口微创入路组(ZW组)36例(37足),行纵行复位小切口入路治疗方案；跗骨窦微创入路组(FW组)31例(33足),行跗骨窦间隙入路治疗方案。根据X线片对比2组患者手术前后的Bohler角、Gissane角、并发症、愈合时间、跟骨内骨折术后AO-FAS踝关节与足后评分。结果 ZW组愈合时间、Bohler角、Gissane角等指标均优于FW组,但组间比较无显著性差异(P>0.05)；ZW组切口感染并发症明显少于FW组,组间比较差异具有统计学意义(P<0.05)；评分结果显示ZW组得分为82.49分,FW组得分为86.53分,组间比较无统计学意义(P>0.05)。结论2种治疗手段虽无明显差异,但经纵行小切口复位微创入路治软组织损伤程度、术后愈合时间、手术并发症等临床效果更为满意。
목적：탐토종행절구화부골두미창입로재근골관절내골절치료중적림상료효。방법회고성분석2008년3월지2012년3월아원수치적67례종행절구혹부골두미창입로술치료병근종수방적근골관절내골절환자적림상자료,안조수술류형분위2조：종행절구미창입로조(ZW조)36례(37족),행종행복위소절구입로치료방안；부골두미창입로조(FW조)31례(33족),행부골두간극입로치료방안。근거X선편대비2조환자수술전후적Bohler각、Gissane각、병발증、유합시간、근골내골절술후AO-FAS과관절여족후평분。결과 ZW조유합시간、Bohler각、Gissane각등지표균우우FW조,단조간비교무현저성차이(P>0.05)；ZW조절구감염병발증명현소우FW조,조간비교차이구유통계학의의(P<0.05)；평분결과현시ZW조득분위82.49분,FW조득분위86.53분,조간비교무통계학의의(P>0.05)。결론2충치료수단수무명현차이,단경종행소절구복위미창입로치연조직손상정도、술후유합시간、수술병발증등림상효과경위만의。
Objective To compare the application value and the clinical curative effect of longitudinal incision and tarsal sinus minimal-ly invasive approach in treatment of patients with intra-articular calcaneal fractures. Methods A retrospective statistical analysis was made by collecting and comparing the clinical data of 67 patients with intra-articular calcaneal fractures from March 2008 to March 2012,and they were divided into the longitudinal incision minimally invasive approach group ( ZW group,36 patients,37 feet) and the tarsal sinus minimally invasive approach group ( FW group,31 patients,33 feet) . The Bohler angle, Gissane angle before and after operation,complications healing time,and AOFAS scores were compared. Results The healing time,Bohler angle,Gissane angle of ZW group and other indicators were better than those of the FW group,but there was no significant difference between the two groups (P>0. 05). The infection of incision and compli-cations in ZW group was obviously less than those of the FW group (P<0. 05). According to the AOFAS scoring system,ZW group scored 82. 49 points while FW group scored 86. 53 points,which indicated no statistical significance (P>0. 05). Conclusion The two kinds of treatments are of no obvious difference,but the longitudinal small incision minimally invasive approach could receive better effect in terms of soft tissue damage,healing time,and postoperative complications.