摘要
目的探究经跗骨窦入路复位微创钢板固定对跟骨骨折患者术后恢复情况及血清超氧化物歧化酶(SOD)、丙二醛(MDA)、肿瘤坏死因子-α(TNF-α)的影响。方法选择我院2019年10月—2022年10月收治的100例跟骨骨折患者为研究对象,按随机数字表法分为对照组、观察组,每组50例。对照组行L型切口复位内固定术,观察组行经跗骨窦入路复位微创钢板固定术。对比两组患者的术后恢复情况、血清指标、足踝功能及并发症发生情况。结果观察组的手术时间、住院时间、骨折愈合时间分别为(65.53±5.20)min、(12.38±1.16)d、(11.65±1.23)周,均短于对照组,术中出血量、术后引流量分别为(25.95±2.18)mL、(49.78±5.95)mL,均少于对照组,组间差异有统计学意义(P<0.05)。观察组术后7 d的SOD水平为(53.46±5.21)kU/L,高于对照组,MDA、TNF-α水平分别为(4.31±0.85)μmol/L、(23.61±3.39)ng/L,均低于对照组,组间差异有统计学意义(P<0.05)。观察组术后3个月的美国矫形外科足踝协会踝-后足评分系统中疼痛、功能、力线评分分别为(30.12±2.53)分、(31.49±3.52)分、(7.29±0.91)分,均高于对照组,组间差异有统计学意义(P<0.05)。观察组的并发症发生率为4.00%,低于对照组的18.00%,差异有统计学意义(P<0.05)。结论采用经跗骨窦入路复位微创钢板固定治疗跟骨骨折,可减轻患者应激、炎症反应,减少并发症,促进术后恢复,改善足踝功能。
Objective To investigate the effects of minimally invasive plate fixation via tarsal sinus approach on postoperative recovery and serum superoxide dismutase(SOD),malondialdehyde(MDA)and tumor necrosis factor-α(TNF-α)in patients with calcaneal fracture.Methods 100 patients with calcaneal fracture admitted to the hospital from October 2019 to October 2022 were selected as the research objects and were divided into a control group and an observation group according to random number table method,with 50 cases in each group.The control group underwent L-shaped incision reduction and internal fixation,and the observation group underwent minimally invasive plate fixation via tarsal sinus approach.The postoperative recovery,serum indexes,foot and ankle function and complications were compared between the two groups.Results The operation time,hospital stay and fracture healing time in the observation group were(65.53±5.20)min,(12.38±1.16)d and(11.65±1.23)weeks,respectively,which were shorter than those in the control group,the intraoperative blood loss and postoperative drainage volume were(25.95±2.18)mL and(49.78±5.95)mL,respectively,which were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).7 days after surgery,the SOD level in the observation group was(53.46±5.21)kU/L,higher than that in the control group,while the MDA and TNF-α levels were(4.31±0.85)μmol/L and(23.61±3.39)ng/L,respectively,lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).3 months after surgery,the pain,function and force line scores of the American Orthopedic Foot and Ankle Society in the observation group were(30.12±2.53)points,(31.49±3.52)points and(7.29±0.91)points,respectively,which were higher than those in the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of complications in the observation group was 4.00%,lower than 18.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion The treatment of calcaneal fracture with minimally invasive plate fixation via tarsal sinus approach can reduce stress and inflammation,reduce complications,promote postoperative recovery and improve ankle function.
作者
孙永强
王小鹤
SUN Yongqiang;WANG Xiaohe(Department of Orthopedics,Zhangqiu District Hospital of Traditional Chinese Medicine,Jinan Shandong,250200,China)
出处
《反射疗法与康复医学》
2023年第11期155-158,共4页
Reflexology And Rehabilitation Medicine
关键词
跟骨骨折
跗骨窦入路
钢板固定
术后恢复
血清指标
足踝功能
并发症
Calcaneal fracture
Sinus tarsi approach
Steel plate fixation
Postoperative recovery
Serum indicators
Ankle function
Complication
作者简介
孙永强(1976-),男,山东济南人,本科,主治医师,研究方向:骨外科疾病诊治。
