跟骨关节内移位骨折手术治疗螺钉并发症防范的探讨  

Prevention of screw-related complications in surgical treatment for fresh displaced intra-articular calcaneal fractures

作　　者：王小平[1] 吴玮伟[1] 黄俭[1] 陈路遥[1] 胡世锵[1] 韦展图[1] 梅建兵[1] 屠玉民[1] 

机构地区：[1]广东省中山市南方医科大学附属小榄医院创伤脊柱外科,528415

出　　处：《实用医学杂志》2015年第4期614-617,共4页The Journal of Practical Medicine

基　　金：广东省医学科学技术研究基金科研课题(编号:2011B363)

摘　　要：目的:探讨总结跟骨钢板治疗新鲜跟骨关节内移位骨折的螺钉问题。方法:回顾我院2009年12月至2013年3月采用跟骨解剖钢板治疗42例(48足)新鲜移位跟骨关节内骨折患者的资料。对术后出现的螺钉并发症进行分析。结果:术后末次随访48足Maryland足部功能评分平均为87.8分,其中优21足,良19足,可8足,差0足,优良率为83.3%。4例患者出现螺钉并发症,其中3例螺钉进入关节间隙内,1例螺钉松动退钉,螺钉并发症发生率为8.3%。结论:充分的术前准备,熟悉跟骨解剖知识和细致准确的手术操作,术中影像学检查可降低螺钉医源性损伤。Objective To explore and summarize the screw-related complications in treatment with anatomical calcaneal plate tot fresh calcaneal intra-articular fractures. Methods The data on 42 patients who had received caleaneal anatomical plate for 48 fresh displaced intra-articular caleaneal fractures during the period of December 2012 to March 2013 were retrospectively analyzed. The postoperative screw-related complications were analyzed. Results At the last post-operative follow-up of all 42 patients （48 feet）,according to the Maryland score, the outcome was excellent in 21 filet, good in 19, and fair in 8, with an ideal treatmnt rate of 83.3%. Three patients had entering of serews into the arlicular space and one patient occurred screw loosening, with a rate of screw-related complications of 8.3%. Conelusions Adequate preoperative preparation,being familiar withanatomy of the ealcaneus,careful surgical operation, and intraoperative imaging examination can markedly reduce the screw-related iatrogenic injury.

关 键 词：跟骨 关节内骨折 内固定 螺钉 

分 类 号：R687.3[医药卫生—骨科学]