外侧直切口治疗跟骨关节内骨折早期并发症分析  

EARLY COMPLICATIONS ANALYSIS TO LATERAL STRAIGHT INCISION FOR INTRA-ARTICULAR FRACTURE OF CALCANEUS

作　　者：王振虎[1] 孙辉生[1] 高成杰[1] 侯利军[1] 李天旺[1] 

机构地区：[1]中国人民解放军第252医院关节外科,河北保定071000

出　　处：《河北医科大学学报》2010年第2期153-156,共4页Journal of Hebei Medical University

摘　　要：目的通过对跟骨外侧直切口治疗跟骨关节内骨折的疗效观察,对其并发症进行分析。方法 1999年1月-2008年5月,对70例87足跟骨关节内骨折在适当的时机采用跟骨外侧直切口行手术治疗,观察骨折情况及Gissane角的改变。将骨折撬拨复位并手法挤压塑形,恢复跟骨外形、距下关节解剖形态及足弓,克氏针临时固定,选择合适的可塑性跟骨钛钢板自切口内置入并调整,C型X线机臂下观察跟骨侧位、轴位,骨折复位及跟骨板位置良好,分别用松质骨螺钉经过跟骨板钉孔将骨折三点固定,骨缺损部植入自体或异体骨填充。结果 70例87足全部获得随访,随访时间8～24个月,术后并发症发生率12.6%(11足)。根据Maryland足部评分标准,优良率86.2%。结论跟骨外侧直切口,创伤小,血运破坏少,术后并发症发生率低。Objective To observe the therapeutic effect of lateral straight incision on intraarticular fracture of calcaneus and analysis the complications of this method. Methods Seventy patients with 87 feet of intra-articular fracture of calcaneus were treated in proper opportunity from January 1999 to May 2008. The lateral straight incision of calcaneus was adopted. Observe the fracture information and Gissane angle＂ s change. The fracture reduction was completed with percutaneous reduction by leverage and pressurization moulding with skill. The bone fracture were temporarily fixed by Kirschner wire after the calcaneal form and the anatomic form of subtalar joint and instep recovered. The suitable plastic Ti-nickelelad was inserted from the incision and adjusted. The x-ray fluoroscopic monitoring was performed by C-arm to observe the lateral view and axial view of calcaneus,the bone fracture reposition and the location of calcaneat bone plate was well. The bone fracture was fixed with cancellous bone screw by countersink of calcaneal bone plate in tris-point. The autogenous bone or allogenic bone was implanted to the severe bone defect. Results Seventy patients with 87 feet of intra-articular fracture of caleaneus were followed up from 8 to 24 months, the incidence rate of complications after operation wag 12.6%. The total excellent and good rate was 86.2% according to Maryland score system. Conclusion Lateral straight incision is an effective treatment for fracture of calcaneus with advantages of small wound, little destruction to blood supply and lower incidence rate of complications after operation.

关 键 词：跟骨 骨折 手术后并发症 

分 类 号：R683.42[医药卫生—骨科学]