跗骨窦联合外侧小切口治疗Sanders Ⅲ型跟骨骨折

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Abstract

Objective To investigate open reduction and internal fixation via sinus tarsi approach with anatomical locking plate in the treatment of sanders type Ⅲ calcaneal fractures.Methods Thirty-eight patients with unilateral Sanders type Ⅲ calcaneal fracture were recruited from February 2013 to February 2015.Patients were randomly divided into minimally invasive group and control group by random table method，with 19 cases in each group.The baseline information including age，sex，fracture cause，interval time from injury to operation，B-hler angle and Gissane angle before operation was analysed.All patients in the minimal invasive group underwent open reduction and internal fixation (ORIF) using sinus tarsi approach，and lateral L-type incision in the control group.B-hler angle and Gissane angle were measured before and after operation and the final follow-up inboth the two groups.American Orthopaedic Foot and Ankle Society(AOFAS) score were approved to evaluate the therapeutic effect after operation.Results There was no significant difference in age，sex，fracture cause，interval time from injury to operation，B-hler angle and Gissane angle before operation between the two groups.The average follow-up time was 14.1 months in minimal invasive group，and 14.8 months in control group.All patients in the two groups had bone union in final follow-up.B-hler angle was (12.9±5.4)° and (11.7±5.1)° in minimal invasive andcontrol group before operation.After operation，B-hler angle were (27.2±5.3)°in minimal invasive group and (28.1±6.3)° in the control group.Gissane angle was (108.5±8.6)° and (109.9±8.2)° beforeoperation in minimal invasive and control group.Gissane angle of observation group was (123.3±5.0)° and the control group was (124.7±5.4)° after operation.There was significant difference in B-hler angle and Gissane angle before andafteroperation in both minimal invasive group and control group (P＜0.05).No significant difference was found in the median AOFAS score between the two groups (P＞0.05).Three of skin necrosis and 1 of superficial infection were found in the control group，and no wound complications in the minimal invasive group.Three patients suffered from varying degrees of subtalar joint stiffness and 1 patients suffered from traumatic arthritis in the minimal invasive group，and there were9patients ofsubtalar joint stiffness and 3 patientsof traumatic arthritis in the control group.Conclusion ORIF via sinus tarsi approach and ORIF via a lateral L-type incisionhave similar therapeutic effect in the management of sanders type Ⅲ calcaneal fractures.And there are less incision complication and lower stiffness subtalar joint rate inORIF via sinus tarsi approach Patients.

Key words： calcaneus fractures sinus tarsi fracture fixation internal

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	Hou Zhengxuan
	Li Jianbo
	Liu Ningbo
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Hou Zhengxuan,Li Jianbo,Liu Ningbo, et al. Open Reduction and Internal Fixation Via Sinus Tarsi Approach Combined with Small Lateral Incision for the Treatment of Sanders Type Ⅲ Calcaneal Fractures[J]. sygkzz, 2018, 24(1): 25-30.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2018/V24/I1/25

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