【摘要】 目的 探讨对SandersⅡ、Ⅲ型跟骨骨折采用跗骨窦切口微型钢板联合空心钉内固定的治疗效果及对踝关节功能及影像学指标的影响。方法 选择阜宁县人民医院骨科2020年1月至2022年1月收治的SandersⅡ、Ⅲ型跟骨骨折患者85例，按照随机数表法分为常规“L”形切口内固定术治疗对照组（n=42）与跗骨窦切口微型钢板联合空心钉内固定治疗观察组（n=43），比较两组手术及康复的相关指标，评估两组术后足部功能优良率，并于术前、术后即刻、术后6个月拍摄X线片观察Bohler角与Gissane角，并统计两组并发症发生率。结果 观察组与对照组比较：术前等待时间、出血量、消肿时间、伤口拆线时间[（4.76±1.04）d、（73.62±14.26）ml、（3.12±1.74）d、（17.35±1.63）d vs(8.03±1.25)d、（97.18±16.48）ml、（6.87±2.05）d、（18.49±2.01）d,P <0.05]；足部功能优良率（95.35%vs 80.95%,P <0.05）；术后即刻、术后6个月Bohler角[（28.73°±4.25°）、（28.42°±4.01°）vs(28.95°±4.47°)、（28.50°±4.32°），P> 0.05]；术后即刻、术后6个月Gissane角[（128.05°±7.10°）、（127.40°±5.68°）vs(128.29°±6.97°)、（127.83°±5.75°），P> 0.05]；术后即刻、术后6个月跟骨高度[（43.10±3.35）mm、（43.85±3.26）mm vs(43.81±3.22)mm、（43.69±3.31）mm,P> 0.05]；术后即刻、术后6个月跟骨宽度[（43.20±2.48）mm、（43.32±2.50）mm vs(43.31±2.55)mm、（43.43±2.48）mm,P> 0.05]；并发症率发生率（4.65%vs 21.43%,P <0.05）。结论 对SandersⅡ、Ⅲ型跟骨骨折予跗骨窦切口微型钢板联合空心钉内固定治疗，能保障手术及时开展，可减轻患者损伤并促进患者康复，有利于改善足部功能，跟骨结构恢复良好，且并发症风险低。更多还原

【Abstract】 Objective To investigate the effect of mini plate combined with hollow nail internal fixation through tarsal sinus incision on ankle function and imaging indexes of Sanders Ⅱ and Ⅲ calcaneal fractures. Methods From January 2020 to January 2022, 85 cases of Sanders Ⅱ and Ⅲ calcaneal fractures were selected from the Department of Orthopedics of Funing County People’s Hospital. They were randomly divided into the control group(n=42) treated with conventional L-shaped incision internal fixation, and the observation group(n=43) treated with tarsal sinus incision mini plate combined with hollow nail internal fixation.The operation and rehabilitation related indicators of the two groups were compared, and the excellent and good rate of foot function after operation was evaluated 6 months after operation, X-ray films were taken to detect Bohler angle and Gissane angle. In addition,the incidence of complications in the two groups were compared. Results Compared with the control group: the waiting time before operation, bleeding volume, detumescence time, wound suture removal time[(4.76±1.04)d,(73.62±14.26)ml,(3.12±1.74)d,(17.35±1.63)d vs(8.03±1.25)d,(97.18±16.48)ml,(6.87±2.05)d,(18.49±2.01)d, P < 0.05]; The excellent and good rate of foot function(95.35% vs 80.95%, P < 0.05); Bohler angle immediately after operation and 6 months after operation[(28.73° ±4.25°),(28.42° ±4.01°) vs(28.95° ±4.47°),(28.50° ±4.32°), P > 0.05]; Gissane angle immediately after operation and 6 months after operation[(128.05° ±7.10°),(127.40° ±5.68°) vs(128.29° ±6.97°),(127.83° ±5.75°), P > 0.05]; Calcaneus height immediately after operation and 6 months after operation[(43.10±3.35)mm,(43.85±3.26)mm vs(43.81±3.22)mm,(43.69±3.31)mm, P > 0.05]; Calcaneus width immediately after operation and 6 months after operation[(43.20±2.48)mm,(43.32±2.50)mm vs(43.31±2.55)mm,(43.43±2.48)mm, P > 0.05]; The complication rate(4.65% vs 21.43%, P < 0.05). Conclusion The treatment of Sanders Ⅱ and Ⅲ calcaneal fractures with tarsal sinus incision mini plate combined with hollow nail internal fixation can ensure the timely operation, reduce the patient’s injury and promote the patient’s recovery, which is conducive to improving the foot function, good calcaneal structure recovery, and low risk of complications.更多还原