[1]吴杭 李强 袁海涛 古鹏 范少勇 邓雄伟.经跗骨窦切口入路跟腓韧带处理对跟骨骨折术后功能影响的临床研究[J].中国中医骨伤科杂志,2026,34(05):39-44.[doi:10.20085/j.cnki.issn1005-0205.260506]
　WU Hang,LI Qiang,YUAN Haitao,et al.Clinical Study on the Effect of Calcaneofibular Ligament Treatment via Sinus Tarsi Approach on Postoperative Function Recovery in Patients with Calcaneal Fractures[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(05):39-44.[doi:10.20085/j.cnki.issn1005-0205.260506]
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经跗骨窦切口入路跟腓韧带处理对跟骨骨折术后功能影响的临床研究()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第34卷
期数:
2026年05期
页码:
39-44
栏目:
临床研究
出版日期:
2026-05-10

文章信息/Info

Title:
Clinical Study on the Effect of Calcaneofibular Ligament Treatment via Sinus Tarsi Approach on Postoperative Function Recovery in Patients with Calcaneal Fractures
文章编号:
1005-0205(2026)05-0039-06
作者:
吴杭 李强 袁海涛 古鹏 范少勇 邓雄伟
1南昌市洪都中医院(南昌,330038)
Author(s):
WU Hang1; LI Qiang1; YUAN Haitao1; GU Peng1; FAN Shaoyong1; DENG Xiongwei1△
1Nanchang Hongdu Hospital of Traditional Chinese Medicine,Nanchang 330038,Jiangxi China.
关键词:
跟骨骨折;  跗骨窦切口;  跟腓韧带;  功能恢复;  踝关节不稳
Keywords:
calcaneal fracture;  sinus tarsi approach;  calcaneofibular ligament;  functional recovery;  ankle instability
分类号:
R683.42
DOI:
10.20085/j.cnki.issn1005-0205.260506
文献标志码:
A
摘要:
目的:探讨在经跗骨窦切口入路治疗跟骨骨折时,术中修复跟腓韧带与否对患者术后中远期功能恢复的影响。方法:回顾性分析2022年1月至2023年12月收治的60例Sanders Ⅱ/Ⅲ型跟骨骨折患者的临床资料,所有患者均采用经跗骨窦切口入路手术治疗。根据术中是否修复跟腓韧带,将患者分为跟腓韧带修复组(n=30)和跟腓韧带未修复组(n=30)。比较两组患者的手术时间、术中出血量、骨折愈合时间、骨折复位质量。术后对所有患者进行至少12个月的随访,采用美国足踝外科协会(AOFAS)踝-后足评分及Maryland足部评分系统评估功能恢复情况,采用视觉模拟量表(VAS)评分评估疼痛程度,并记录切口并发症、主观踝关节不稳及距下关节炎早期影像学表现等不良事件的发生率。结果:跟腓韧带未修复组的手术时间为(53.29±11.37)min,显著短于跟腓韧带修复组(68.73±10.35)min,差异有统计学意义(P<0.05),但两组患者术中出血量差异无统计学意义(P>0.05)。所有患者骨折均达到骨性愈合,两组患者骨折愈合时间及骨折复位质量差异无统计学意义(P>0.05)。术后12个月,跟腓韧带修复组的AOFAS评分(89.53±6.22)分显著高于跟腓韧带未修复组的(82.31±7.54)分; 跟腓韧带修复组的Maryland评分(90.07±4.81)分亦显著高于跟腓韧带未修复组的(83.62±5.47)分; 跟腓韧带修复组的VAS评分(1.34±0.72)分,显著低于跟腓韧带未修复组的(2.14±0.93)分,差异有统计学意义(P<0.05)。此外,跟腓韧带修复组主观踝关节不稳发生率为3.3%,跟腓韧带未修复组主观踝关节不稳发生率为20.0%,两组比较差异有统计学意义(P<0.05)。两组患者在切口并发症和距下关节炎早期影像学表现方面差异无统计学意义(P>0.05)。结论:在经跗骨窦切口入路治疗跟骨骨折时,修复跟腓韧带虽然会略微延长手术时间,但能显著改善患者的中远期功能评分,减轻疼痛,并有效降低术后踝关节不稳的风险,从而获得更优的临床疗效。
Abstract:
Objective:To explore the impact of intraoperative calcaneofibular ligament(CFL)repair on the medium and long-term functional recovery in patients with the treatment of calcaneal fractures via the tarsal sinus incision approach.Methods:A retrospective analysis was conducted on the clinical data of 60 patients with Sanders type Ⅱ/Ⅲ calcaneal fractures who were admitted between January 2022 and December 2023.All patients were treated with surgery via the tarsal sinus incision approach.According to whether the calcaneofibular ligament was repaired during the operation,the patients were divided into the CFL repair group(n=30)and the CFL non-repair group(n=30).The operation time,intraoperative blood loss,fracture healing time,and quality of fracture reduction were compared between the two patient groups.All patients were followed up for at least 12 months after the operation.The functional recovery was evaluated using the American orthopaedic foot & ankle society(AOFAS)ankle-hindfoot score and the Maryland foot score.The degree of pain was evaluated by the visual analogue scale(VAS).The incidence of adverse events-including incision-related complications,subjective ankle instability,and early imaging findings suggestive of subtalar arthritis-was also recorded.Results:The operative time of the CFL non-repair group was(53.29±11.37)min,which was significantly shorter than that of the CFL repair group(68.73±10.35)min,and the difference was statistically significant(P<0.05).However,there was no significant difference in intraoperative blood loss between the two groups(P>0.05).All patients achieved bony union of fractures.There was no significant difference in fracture healing time or fracture reduction quality between the two groups(P>0.05).At 12 months after the operation,the AOFAS scores of the CFL repair group(89.53±6.22)points were significantly higher than that of the CFL non-repair group(82.31±7.54)points.The Maryland scores of the CFL repair group(90.07±4.81)points were also significantly higher than that of the CFL non-repair group(83.62±5.47)points.The VAS scores of the CFL repair group were(1.34±0.72)points,which were significantly lower than that of the CFL non-repair group(2.14±0.93)points,and the difference was statistically significant(P<0.05).In addition,the incidence of subjective ankle instability in the CFL repair group was 3.3%,and that in the CFL non-repair group was 20.0%.There was a statistically significant difference between the two groups(P<0.05).There was no significant difference between the two groups in terms of incision-related complications and early imaging findings of subtalar arthritis.Conclusion:When treating calcaneal fractures through the tarsal sinus incision approach,although the repair of the calcaneal peroneal ligament slightly prolongs the operation time,it can significantly improve the medium- and long-term functional scores,reduces pain,and effectively lowers the risk of postoperative ankle instability,thereby achieving better clinical efficacy.

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(收稿日期:2025-10-16)

备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(82560946)
江西省自然科学基金项目(2025BAC200562)
江西省卫生健康委科技计划(SKJP220219574)
江西省中医药中青年骨干人才(第一批)培养计划项目(赣中医药科教字〔2020〕2号)
南昌市市级重点专科建设项目(洪卫体改字〔2023〕10号)
△通信作者 E-mail:dengxiongwei1130@163.com
更新日期/Last Update: 2026-05-15