数字化技术辅助微创经皮螺钉固定距骨后突骨折的临床研究

目的　探讨应用数字化技术辅助微创经皮螺钉固定治疗距骨后突骨折的临床疗效。 方法　选择2014年6月至2018年12月收治的距骨后突骨折病例19例，其中男13例，女6例；年龄28~57岁，平均37.7岁；车祸伤5例，高处坠落伤11例，扭伤3例；单纯距骨后突骨折11例，合并距下关节脱位4例，合并踝关节骨折2例，合并跟骨骨折2例。应用数字化技术进行微创手术。采用AOFAS踝-后足评分、视觉模拟评分（VAS）评价术前及末次随访时患足功能。 结果　19例患者均获随访，随访时间9~22月，平均14.2月，所有患者无切口感染、骨折移位、血管神经损伤、骨不愈等并发症出现。AOFAS踝-后足评分：术前（38.8±12.4）分，术后（87.0±6.4）分，17例优，2例良；VAS评分：术前（4.8±1.2）分，术后（1.0±0.7）分。 结论　应用数字化技术辅助微创经皮螺钉固定治疗距骨后突骨折可提高手术精确度、缩短手术时间、减少手术创伤，具有良好的疗效。

Clinical study of minimally invasive percutaneous screw fixation for digital treatment of talar posterior process fractures

Objective　To investigate the clinical effect of digital technology assisted minimally invasive percutaneous screw fixation in the treatment of talar posterior process fractures.　Methods　A total of 19 patients with talar fracture treated from June 2014 to December 2018 were selected, including 13 males and 6 females, aged from 28 to 57 years, with an average of 37.7 years. The causes of injury were 5 cases of car accident injuries, 11 cases of fall injuries from heights, and 3 cases of sprains. There were 11 cases of talar posterior process fracture, 4 cases of subtalar joint dislocation, 2 cases of ankle fracture, and 2 cases of calcaneus fracture. Digital technology was used to perform precise minimally invasive surgery on the above patients. The AOFAS Ankle Hindfoot Scale and Visual Analogue Score (VAS score) were used to evaluate the function of the affected foot before operation and at the last follow-up.　Results　Nineteen patients were followed up for 9 months to 22 months, with an average of 14.2 months. All patients had no complications such as incision infection, fracture displacement, vascular and nerve injury, and unhealed bone. AOFAS ankle-hindfoot score: preoperative (38.8±12.4) points and postoperative (87.0 ±6.4) points. VAS score: preoperative (4.8±1.2) points and postoperative (1.0±0.7) points. The AOFAS ankle- hindfoot score was excellent in 17 cases of patients and good in 2 cases of patients.　Conclusions　The application of digital technology assisted minimally invasive percutaneous screw fixation in the treatment of talar posterior process fractures can improve the accuracy of surgery, shorten the operation time, and reduce surgical trauma.