摘要
目的 分析儿童跟骨关节内骨折外科治疗效果。方法 回顾性分析2011年1月~2014年12月四川省泸州医学院附属医院骨与关节外科收治的27例29足跟骨关节内骨折患儿的临床资料,按照治疗方法将其分为撬拨复位空心螺钉内固定组（空心螺钉组）7例（8足）,经跗骨入路复位克氏针内固定治疗组（克氏针组）12例（13足）,非手术组8例（8足）。观察各组患儿的术后并发症及骨折愈合情况;测量Bohler角及Gissane角;比较各组美国足与踝关节协会（AOFAS）主观评分情况。结果 经过积极的手术与非手术治疗,三组患儿获得了良好的疗效,均获得了为期12~36个月的随访,克氏针组及空心螺钉组患儿均未出现伤口感染、骨折移位、内固定断裂等。在末次随访中,非手术组患儿X线复查跟骨Bohler角[（30.7±2.3）°]及Gissane角[（126.7±21.2）°]与治疗前比较[（30.2±2.5）°、（126.2±18.5）°],差异均无统计学意义（P〉0.05）;治疗后克氏针组及空心螺钉组Bohler角及Gissane角[克氏针组：（31.2±4.5）°、（126.2±20.1）°;空心螺钉组（30.9±3.8）°、（126.0±17.8）°]与治疗前[克氏针组：（10.9±2.2）°、（141.2±20.9）°;空心螺钉组（11.1±1.6）°、（145.3±22.3）°]比较,差异均有统计学意义（P〈0.05）,治疗前及治疗后组间比较,差异均无统计学意义（P〉0.05）。结论 撬拨复位空心螺钉内固定与经跗骨入路复位克氏针内固定治疗足骨关节内骨折患儿均可获得满意的效果,临床治疗中应根据患儿的伤情选择合理的治疗方式。
Objective To analyze the effect of surgical treatment in children with intra-articular calcaneal fractures. Methods Clinical data of 27 children （29 feet） with intra-articular calcaneal fractures from January 2011 to December 2014 in Deparment of Bone and Joint Surgery of Affiliated Hospital of Luzhou Medical College were retrospectively analyzed. They were divided into prying reduction hollow screw internal fixation group （8 feet of 7 cases, hollow screw group）, restoration Kirschner wire fixation via tarsi approach group （13 feet of 12 cases, Kirschner wire group） and non- surgical group （8 feet of 8 cases） according to the treatment. The postoperative complications and healing of patients in three groups were observed; the Bohler angle and Gissane angle were measured; the foot and ankle society （AOFAS） subjective scoring of three groups were compared. Results After a positive surgical and non-surgical treatment, children of the three groups obtained good curative effect, all were followed-up for 12-36 months, there was no wound infection, fracture displacement, fracture of internal fixation occurred in Kirschner wire group and hollow screw group. At the last follow-up, X-ray detection showed that, the Bohler angle [（30.7±2.3）°] and Gissane angle [（126.7±21.2）°] had no statistically significant difference with those before treatment [（30.2±2,5）°,（126.2±18.5）°] （P 〉 0.05）; after treatment, the Bohler angle and Gissane angle of Kirschner wire group ＇and hollow screw group [Kirschner wire group： （31.2±31.2）°, （126.2±20.1）°; hollow screw group： （30.9±3.8）°, （126.0±17.8）°] were statistically significant different with those before treatment [Kirsehner wire group （10.9±10.9）°, （141.2±20.9）°; hollow screw group： （11.1±1.6）°, （145.3±22.3）°] （P 〈 0.05）; the differences before and after treatment of two groups were not statistical significance （P 〉 0.05）. Conclusion Prying reset the hollow screw fixation and restoration Kirschner wire fixation via tarsi approach in the treatment of the children with intra-articular fracturecan obtain satisfactory results, it is important to choose the reasonable treatment according to the patient＇s condition.
出处
《中国医药导报》
CAS
2015年第21期55-58,62,共5页
China Medical Herald
关键词
儿童
跟骨关节内骨折
撬拨复位空心螺钉内固定
跗骨入路复位克氏针内固定
疗效
Children
Intra-articular calcaneal fractures
Prying reset the hollow screw fixation
Tarsi approach restoration gram needle fixation
Curative effect
