Orthopedic Surgery, the Hospital of Yan Qing County Bei Jing
目的 对比跗骨窦入路和传统扩大L型入路切开复位钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折临床疗效。 方法 回顾性研究2018年1月～2020年10月收治80例跟骨骨折患者临床资料，其中跗骨窦入路38例，传统L型入路42例。两组患者均由同一组医生完成手术，记录两组患者手术切口长度、术中出血量、术后引流量、住院时间、骨折愈合时间、负重时间、术后切口并发症基本资料，并进行比较分析。记录两组患者手术前后及随访时B?hler角、Gissane角，美国足踝协会脚踝与后足功能评分（AOFAS），并对其结果进行比较分析。 结果 将围手术期资料进行统计分析，跗骨窦组在手术切口长度、术中出血量、术后引流量、住院时间、骨折愈合时间、负重时间、术后切口并发症，经统计分析差异具有统计学意义（P＜0.05），跗骨窦入路优于传统L入路。术前 B?hler 角、术后 B?hler 角、末次随访B?hler角；术前Gissane角、术后Gissane角、末次随访Gissane角，数据进行统计分析，两组间无显著差异。两组患者的AOFAS评分，在总分、疼痛、活动限制、行走距离功能，差异无统计学意义（P＞0.05）。跗骨窦组AOFAS行走路面评分(4.21±1.48)分高于传统L入路组（3.26±1.68）分，差异具有统计学意义（P＜0.05P）。结论 跗骨窦入路钢板内固定术治疗Sanders II、III型跟骨骨折具有手术切口短、术中出血量及术后引流量少、住院时间、骨折愈合时间及负重时间短、总的手术切口并发症低优点。提高术后后足功能的恢复速度，较传统L型切口钢板内固定术具有更好的疗效，具有临床应用价值，值得推广。
Objective To compare the clinical efficacy of tarsal sinus approach and traditional extended L-shaped approach open reduction plate internal fixation to treat Calcaneal fractures of Sanders II and III. Methods From January 2018 to October 2020, Retrospective study the datas of 80 patients with calcaneal fracture, There were 38 cases of tarsal sinus approach and 42 cases of traditional L - shaped approach. Operations of both groups were performed by the same group of doctors, The patient datas of the two groups were recorded, length of surgical incision, intraoperative blood loss, postoperative drainage volume, length of hospital stays, fracture healing time, weight bearing time and postoperative incision complications，and make a comparative analysis. B?hler angle and Gissane angle were recorded before and after operation and during follow-up.American Foot and Ankle Association Ankle and Hindfoot Function Score (AOFAS) ，its results were compared and analyzed. Result The perioperative data were analyzed statistically，in the tarsal sinus group, incision length, intraoperative blood loss, postoperative drainage volume, hospital stay, fracture healing time, weight-bearing time, postoperative incision complications,the difference was statistically significant (P <0.05), the sinus tarsus approach is superior to the traditional L approach. Preoperative B?hler Angle, postoperative B?hler Angle, the last follow-up B?hler Angle; Preoperative Gissane Angle, postoperative Gissane Angle, last follow-up Gissane Angle, statistical analysis showed no significant difference between the two groups. AOFAS score of 2 groups, total score, pain score, activity limitation score, walking distance function score, there was no statistically significant difference (P > 0.05). AOFAS walking score of tarsal sinus group (4.21±1.48) was higher than the score of traditional L approach group (3.26±1.68), the difference was statistically significant (P < 0.05P).Conclusion Plate internal fixation through tarsal sinus approach to treat the calcaneal fractures of Sanders II and III type has the following advantages: Shorter incision, less intraoperative blood loss and postoperative drainage, shorter hospital stay, shorter fracture healing time and weight bearing time, and lower overall incision complications. It can improve the recovery speed of postoperative foot function, and has better efficacy than traditional L-shaped incision plate internal fixation, which has clinical application value and is worthy of promotion.