| 摘要: |
| 目的:探讨经跗骨窦入路复位微创钢板固定治疗对SandersⅡ、Ⅲ型跟骨骨折患者术后足部功能和血清炎症因子水平的影响。方法:选择2021 年1 月—2023 年1 月于新疆医科大学第一附属医院接受手术治疗的212 例SandersⅡ、Ⅲ型跟骨骨折患者，采用随机数字表法分为观察组(106 例，经跗骨窦入路复位微创钢板固定术)和对照组(106 例，L 形切口复位内固定术)。比较两组疗效、手术情况、足部功能、血清炎症因子[肿瘤坏死因子-a(TNF-a)、白细胞介素-6(IL-6)和白细胞介素-10(IL-10)]以及并发症发生情况。结果:观察组治疗优良率(94.34%)高于对照组(85.85%)，差异有统计学意义(P<0.05)。观察组手术时间、术中出血量、术中平均透视次数、术后引流量、术后24 h 疼痛评分、住院时间、骨折愈合时间均少于对照组(P＜0.05)。术后，两组Boher 角、Gissane 角均扩大，但组间差异不明显( 跃0.05)；两组Maryland 足功能评分升高，且观察组高于对照组(P＜0.05)。术后，两组血清TNF-a、IL-6 和IL-10 水平先升高后降低，且观察组术后1 d、5 d 的血清TNF-a、IL-6 和IL-10 水平均低于对照组(P＜0.05)。观察组并发症发生率(2.83%)低于对照组(10.38%)，差异有统计学意义(P＜0.05)。结论:经跗骨窦入路复位微创钢板固定治疗SandersⅡ、Ⅲ型跟骨骨折效果显著，可以改善患者术后足部功能，减少炎症刺激，加速康复，且并发症少，值得推广。 |
| 关键词: 经跗骨窦入路 微创钢板固定 跟骨骨折 足部功能 炎症因子 |
| DOI：10.3969/j.issn.1007-6948.2024.05.014 |
| 投稿时间：2023-12-03 |
| 基金项目: |
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| Effect of minimally invasive plate fixation via tarsal sinus approach on postoperative foot function and serum inflammatory factor levels in patients with Sanders Ⅱand Ⅲcalcaneal fractures BU Jian-wen, |
| XIE Zeng -ru. |
| Department of Trauma and Orthopedics,the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, China |
| Abstract: |
| Objective To investigate the effects of minimally invasive plate fixation via tarsal sinus approach on postoperative foot function and serum inflammatory factor levels in patients with SandersⅡand Ⅲcalcaneal fractures. Methods 212 patients with SandersⅡand Ⅲcalcaneal fracture who received surgical treatment in the First Affiliated Hospital of Xinjiang Medical University from January 2021 to January 2023 were selected and divided into observation group (106 cases with minimally invasive plate fixation via tarsal sinus approach) and control group (106 cases with L-shaped incision reduction and internal fixation) by random number table method.The therapeutic effect, operation status, foot function, serum inflammatory factors [tumor necrosis factor-a(TNF-a), interleukin-6 (IL-6) and interleukin-10 (IL-10)] and the incidence of complications were compared. Results The rate of excellent and good treatment in observation group (94.34%) was higher than that in control group (85.85%), the difference was statistically significant (P<0.05). Operation time, intraoperative blood loss,average fluoroscopy times, postoperative drainage volume, postoperative pain score 24 h, hospital stay and fracture healing time in the observation group were all lower than those in the control group (P<0.05). After operation, Boher Angle and Gissane Angle were enlarged in both groups, but there was no significant difference between groups (P>0.05). The Maryland foot function scores of both groups were increased, and the observation group was higher than the control group (P<0.05). After surgery, serum levels of TNF-a, IL-6 and IL-10 in both groups first increased and then decreased, and the serum levels of TNF-a, IL-6 and IL-10 in the observation group were lower than those in the control group on day 1 and day 5 after surgery (P<0.05). The complication rate of observation group (2.83%) was lower than that of control group (10.38% ), which the difference was statistically significant (P<0.05). Conclusion Minimally invasive plate fixation via tarsal sinus approach for the treatment of SandersⅡand Ⅲcalcaneal fractures has significant effects, which can improve postoperative foot function, reduce inflammatory stimulation, accelerate recovery, and reduce complications, which is worthy of promotion. |
| Key words: Transtarsal sinus approach minimally invasive plate fixation calcaneus fracture foot function inflammatory factor |
