经皮撬拨复位加石膏固定治疗跟骨骨折  

Percutaneous Reduction Combined with Cast Immobilization for Calcaneal Fracture

作　　者：萧文耀[1] 马远[2] 张超[1] 丁轩玺[1] 陶贵彦[1] 张晓霞[1] 陈根元[1] 

机构地区：[1]兰州大学第一医院骨科,兰州730000 [2]甘肃省人民医院骨科,兰州730000

出　　处：《中国微创外科杂志》2012年第6期544-546,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨经皮撬拨复位石膏固定治疗跟骨骨折的近期效果。方法 2002年1月～2008年12月,对SandersⅡ型、Ⅲ型31例(34足)跟骨骨折,在C形臂X线机下,采用经皮斯氏针撬拨复位,石膏固定。结果 34足术后12个月侧位X线,距下关节面达到或接近解剖复位(移位≤2 mm),Bhler角均>30°,Perie角均<15°。经12～24个月随访,无针道感染和骨折再移位、足弓塌陷等并发症,足外形良好,能够穿正常鞋,无跛行,术后6个月骨折全部愈合。按Maryland足部评分系统进行功能评估,优良率达88.2%(30/34足)。结论经皮斯氏针撬拨复位石膏固定,适用于SandersⅡ型、Ⅲ型跟骨骨折,手术微创,固定可靠,简便易行,并发症少,是理想的治疗方法之一。Objective To observe the short-term outcomes of percutaneous reduction combined with east immobilization for calcaneal fracture. Methods From January 2002 to December 2008, 31 patients （34 feet） with calcaneal fracture （Sanders＇ 11 or m ） received C-arm X-ray-guided percutaneous reduction by leverage and axial internal fixation with multiple Steinmann＇ s pins, and then, cast immobilization. Results Twelve months after the surgery, lateral X-ray showed that, in all the patients, the subtalar articular surface recovered anatomically （ displacement ≤ 2 mm ） , Boehler＇ s angle 〉 30 ° and Perie＇ s angle 〈 15 °. All the patients were followed up for an average of 12 -24 months, during which no puncture wound infection, displacement of the fracture fragment, or fallen arches occurred. The shape of the feet was good and the patient walked normally without pain or claudication. The mean fracture healing time was 6 months. According to the Maryland foot score, the rate of excellent and good was 88.2% （30/34）. Conclusions Percutaneous reduction by roentgenography of C-arm with multiple Steinmann＇ s pins is an optimal choice for the treatment of Sanders＇ types I1 and m calcaneal fracture. The procedure is effective, simple, reliable, and minimally invasive with few complications.

关 键 词：跟骨骨折 关节内 撬拨复位 斯氏针 内固定 

分 类 号：R687.3[医药卫生—骨科学]