Objective To compare clinical effect of two kinds of surgical methods in the treatment of calcaneal fractures.Methods 60 patients with fresh and unilateral Sanders Ⅱ,Ⅲ type calcaneal fractures from October 2012 to September 2014 in People's Hospital of Sanxiang were selected,they were divided into group A and group B,with 30 cases in each group,by the simple randomization method.Group A was treated with minimally invasive sinus tarsi approach reduction and plate internal fixation,group B was treated with L-shaped lateral incisiong open reduction and plate internal fixation.The operation time,intraoperative blood loss,the imaging parameters before and after operation,the postoperative complications,Marland foot function scores of two groups were ananlyzed.Results The postoperative Bolher angle,Calcaneal width,Gissane angle and Marland foot function scores were compared,the differences were not statistically significant (P ＞ 0.05).The operation time,intraoperative blood loss and the postoperative complication of group B were better than those of group A,the differences were statistically significant (P ＜ 0.05).Conclusion The minimally invasive incision and reduction of tarsal sinus incision for the treatment of Sanders Ⅱ and Ⅲ calcaneal fractures has satisfactory clinical results,few complications,short operative time and less blood loss during operation.%目的 比较两种不同手术方式治疗跟骨骨折的临床效果.方法 选择广东省中山市三乡医院2012年10月～2014年9月SandersⅡ、Ⅲ的跟骨骨折患者60例,按简单随机化方法随机分成A、B两组,每组各30例,A组采用传统扩大“L”型切口行切开复位钢板螺钉内固定术治疗,B组采用经跗骨窦切口微创有限切开复位内固定术治疗.比较两组手术时间、术中出血量、术前后跟骨影像学参数的恢复情况、术后并发症发生率、Maryland足部功能评分.结果 两组两组术后Bohler角、跟骨宽度、Gissane角、Maryland足部功能评分比较,差异无统计学差异(P＞0.05).两组患者手术时间,手术中出血量、术后并发症发生率比较,B组患者明显优于A组,差异有统计学差异(P＜0.05).结论 经跗骨窦切口微创有限切开复位治疗SandersⅡ、Ⅲ的跟骨骨折临床疗效满意,并发症少,手术时间短,手术中出血量少.
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