不同治疗方法治疗跟骨骨折的疗效比较  

Comparison of different methods in the treatment of calcaneal fracture

作　　者：蔡振宇[1] 张亚东[1] 

机构地区：[1]上海市长宁区中心医院骨科,上海200336

出　　处：《临床骨科杂志》2009年第3期294-295,共2页Journal of Clinical Orthopaedics

摘　　要：目的探讨不同治疗方法治疗跟骨骨折的临床效果。方法对159例跟骨骨折患者根据Sanders分型方法,采用闭合手法撬拨复位外固定治疗38例(Ⅱ型),单纯植骨或内固定56例(Ⅱ型9例、Ⅲ型47例),植骨加内固定65例(Ⅲ型20例、Ⅳ型45例)。结果159例均获随访,时间4～6个月。全部骨性愈合,愈合时间12～20周。跟踝关节功能恢复良好。闭合复位外固定组:优12例,良19例,差2例;单纯植骨或内固定组:优28例,良15例,差2例;植骨加内固定组:优39例,良18例,差0例;总优良率82.39%。结论闭合复位外固定治疗适合SandersⅡ型骨折,单纯植骨或内固定治疗适合Ⅲ型骨折,植骨加内固定治疗适合Ⅲ型以上骨折。Objective To discuss the different methods in the treatment of ealcaneal fractures. Methods 159 cases with calcaeal fractures were reruited, which undergone closed pin reduction and external fixation in 38 cases （ Sanders Ⅱ ） , simple bone graft or internal fixation in 56 cases（ Sanders Ⅱ , Ⅲ ） , and bone graft plus internal fixalion in 65 eases （ Ⅲ, Ⅳ Sanders）. Results 159 cases were followed up for 4 -6 months. All got bony union in 12 -20 weeks with good joint functional recovery. In closed reduction group, the results were excellent in 12 cases, good in 19, and poor in 2; In simple bone graft and internal fixation group, the results were excellent in 28 eases, good in 15, and poor in 2; In bone graft plus internal fixation group, the results were excellent in 39 cases, good in 18, and poor in 0. The total exeellent and good rate was 82.39%. Conclusions According In the Sanders classification for caleaneal fi＇aetures, close reduction treatment is suitable for type Ⅱ , simple bone graft or internal fixation for Ⅲ, and bone graft plus internal fixation for above Ⅲ.

关 键 词：跟骨骨折 骨折固定术 内 关节内骨折 植骨 人工骨 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]