跟骨关节内骨折切开复位与撬拨复位治疗比较  

Open reduction versus poking reduction for treatment of intra - articular calcaneal fractures

作　　者：魏金亮[1] 钟俊[1] 邱波[1] 汪喆[1] 陈亮[1] 

机构地区：[1]武汉大学人民医院骨科,430060

出　　处：《临床外科杂志》2011年第9期632-634,共3页Journal of Clinical Surgery

摘　　要：目的评价跟骨关节内骨折切开复位与撬拨复位的疗效。方法我院自2005年1月至2009年12月收治85例共98足跟骨骨折，成功随访51例58足，其中撬拨复位24足，切开复位34足。按Maryland评分标准进行评价患者术后功能，术后X片Bohler角的恢复情况，患者术后踝关节的活动角度以及VAS疼痛评分法评价患者术后日常生活的自我舒适度。结果随访51例58足，随访率为62．4％；随访时间为3个月～4年，平均23个月。随访时切开复位内固定组及撬拨复位管型石膏固定组Maryland评分、术后踝关节的活动角度以及VAS疼痛评分，各指标比较显示切开复位内固定组均明显优于撬拨复位管型石膏固定组，差异有统计学意义（P〈0．05）。结论对于跟骨关节内骨折，特别是Sanders分型Ⅲ-Ⅳ型患者宜采取切开复位内固定治疗。Objective To evaluate the efficacy of open reduction versus poking reduction in the treatment of intra - articular calcaneal fractures. Methods From January 2005 to December 2009,85 patients with 98 cases of intra - articular calcaneal fractures were treated in our department. A total of 51 patients with 58 cases were followed up, in which 24 cases were treated with poking reduction, and 34 with open reduction. Postoperative function was evaluated by Maryland scoring system; The recovery of Bohler angle was measured by X - ray diffraction ; Ankle activity after sugery was noted ; And the comfort in daily life was measured in terms of VAS pain score. Results Fifty - one patients with 58 cases （ 62.4% ） had successful follow - up （ range, 3 months to 4 years ; mean,23 months ）. During the follow - up, the open reduction with internal fixation group and the poking reduction with plaster cast fixation group had significant differences in Maryland score, postoperative ankle activity and VAS pain score, as in open reduction group all indicators were significantly better（ P 〈 0. 050）. Conclusion Open reduction and internal fixation is recommended for treatment of intraarticular calcaneal fractures,especially those of Sanders type Ⅲ-IV.

关 键 词：跟骨骨折 切开复位 撬拨复位 

分 类 号：R683.42[医药卫生—骨科学]