摘要
背景:尽管目前植入物内固定治疗对许多跟骨骨折患者有效,但在跟骨骨折的分类、治疗、不同植入物内固定治疗方法的选择方面尚未达成一致意见。目的:比较经皮撬拔复位和切开复位后植入物内固定治疗SandersⅡ型跟骨骨折的效果。方法:回顾分析佛山市高明区人民医院骨二科自2010年5月至2012年10月治疗56例SandersⅡ型跟骨骨折的临床资料,年龄15-61岁。采用撬拨复位治疗27例,切开复位植入物内固定治疗29例。结果与结论:所有患者均获得随访,时间为12-24个月,平均16.5个月。治疗后复查X射线片显示跟距关节面基本恢复正常,撬拔复位固定组,Bohler角分别由治疗前的(17.88±2.06)°恢复至治疗后的(30.60±2.89)°,切开复位内固定组,Bohler角分别由治疗前的(17.55±2.46)°,恢复至治疗后的(31.69±2.29)°,经统计两组之间差异无显著性意义(P>0.05)。根据Maryland足部评分系统评价治疗后功能,撬拔复位固定组优14足,良6足,中5足,差2足,优良率74.0%;切开复位植入物内固定组优11足,良13足,中4足,差1足,优良率82.7%,两组优良率差异无显著性意义(P>0.05)。撬拔复位和切开复位植入物内固定方法治疗跟骨骨折都是比较实用有效的选择。SandersⅡ型跟骨骨折应用撬拨复位方法,提高了手术效率和复位质量,是一种有效的方法。
BACKGROUND： Although, implant fixation is effective for many patients with calcaneal fractures, there is no consensus on the classification and treatment of calcaneal fractures as well as the choice of implants interna fixation. OBJECTIVE： To compare the effect of poking reduction and open reduction internal fixation for the treatment of Sanders Ⅱ calcaneal fractures. METHODS： The clinical data of the 56 patients with Sanders Ⅱ calcaneal fractures who treated in the Second Department of Orthopedics, Foshan Gaoming District People＇s Hospital from May 2010 to October 2012 were retrospectively analyzed. The age of the patients was 15-61 years. There were 27 cases treated with poking reduction fixation, and 29 cases were treated with open reduction internal fixation. RESULTS AND CONCLUSION： All the patients were followed-up for 12-24 months, average 16.5 months. The postoperative X-ray film showed talar articular surface of calcaneus was recovered to normal basically. In the poking reduction fixation group, the Bohler angle was recovered from preoperative （17.88±2.06）° to postoperative （30.60±2.89）°; in the open reduction internal fixation group, the Bohler angle was recovered from preoperative （17.55±2.46）° to postoperative （31.69±2.29）°, and there was no significant difference in Bohler angle between two groups （P 〉 0.05）. Evaluation of the postoperative function according to the Maryland foot score showed that in the poking reduction fixation group, there were 14 cases of excellent, six cases of good, five cases of average and two cases of poor, the excellent and good rate was 74.0%; in the open reduction internal fixation group, there were 11 cases of excellent, 13 cases of good, four cases of average and one case of poor, the excellent and good rate was 82.7%. There was no significant difference in the excellent and good rate between two groups （P 〉 0.05）. Both poking reduction fixation and open reduction internal fixation are effective for the treatment of calcaneal fractures.
出处
《中国组织工程研究》
CAS
CSCD
2013年第26期4919-4925,共7页
Chinese Journal of Tissue Engineering Research
基金
佛山市医学类科技攻关项目(201108289)~~
作者简介
熊浩，男，1972年生，江西省宜春市人，汉族，2008年中山大学毕业，副主任医师，副教授。主要从事创伤、脊柱临床研究。1wsurgery@163．com
