跟骨解剖支持板的研制及临床应用  

Clinical Application Research on Treatment of Calcaneal Fracture with Dissection Support Plate

作　　者：孙永强[1] 和艳红[1] 魏景梅[1] 罗小鹏[1] 李晓峰[2] 刘汝银[1] 李志强[2] 

机构地区：[1]河南省中医院,郑州市450002 [2]河南洛阳正骨医院

出　　处：《中国骨与关节损伤杂志》2008年第7期542-544,共3页Chinese Journal of Bone and Joint Injury

基　　金：河南省科技厅资助项目(0496060302)

摘　　要：目的设计跟骨解剖支持板并研究其治疗跟骨骨折的临床应用价值。方法通过对跟骨生物力学和骨折机理的探讨,设计了一种用于跟骨骨折内固定治疗的新型跟骨解剖支持板,并应用该钢板治疗跟骨骨折38例(46足)。其中39足经过6个月以上随访(6～46个月,平均14.6个月)。均行跟骨侧、轴位X线片和CT横轴位、冠状位检查,按Sanders分型,其中Ⅱ型骨折10足,Ⅲ型骨折17足,Ⅳ型骨折12足。手术前后对Bhler角、Gissane’s角、跟骨水平全长、丘部总高、轴长和体宽等多项指标进行比较,采用Marryland足部评分系统评价术后功能。结果术后4例切口延迟愈合,2例腓肠皮神经损伤,1例腓骨长短肌腱滑脱,对症处理后均痊愈。术后功能评价显示:优21足,良15足,可3足,优良率达92.3%。结论跟骨解剖支持板设计合理,结构性能良好,对其进行的多项生物力学测定表明该板可达到跟骨骨折固定的要求。可有效减少并发症,为治疗跟骨骨折提供了一种新的内固定方法。Objective To design a new kind of dissection support plate and study its clinical effect for calcaneal fracture. Methods A new dissection support plate was designed for calcaneal fracture internal fixation to study calcaneal biomechanics and calcaneal fracture mechanism. The plates were used in 38 patients with 46 calcaneal fractures, 39 calcaneal fractures were followed up from 6 months to 46 months （averaged 14.6 months）. Lateral and axial radiographs and CT axial scans of atlases were performed in all patients. Thirtynine fractures were classified according to Sanders classification. Ten fractures were type Ⅱ , 17 type Ⅲ and 12 type Ⅳ. Many targets were observed such as Bohler angle, Gissane＇s angle, the level length, the height in hillock, length in axes and body breadth. The foot function was evaluated according to Marryland criteria of calcaneus fracture reduction. Results Postoperatively, four delayed cicatrization occurred in four patients. The nerve, suralis was injured in 2 patients. The muscle, peroneus longus- brevis surged in one patient. These patients were all completely recovered after treatment. The patients were evaluated using Marryland criteria of calcaneus fracture reduction. The excellent clinical results occurred in 21 calcaneal, good in 15, fair in 3, with the excellent and good clinical results being 92.3 percent. Conclusion The dissection support plate design is reasonable. The structure function is good, with new concept and technique different from traditional internal fixation. This new internal fixation for calcaneus fracture can lead to the best long - term outcomes and reduce complications of caicaneal fracture.

关 键 词：跟骨骨折 内固定 解剖支持板 研制 

分 类 号：R737.9[医药卫生—肿瘤] R683.42[医药卫生—临床医学]