跗骨窦切口联合经皮置钉技术微创治疗Sanders Ⅲ型跟骨骨折  

Sinus tarsi approach for percutaneous pedicle screw in treatment of calcaneal fractures of Sanders type Ⅲ:a minimally invasive technique

作　　者：李来峰[1] 王辉[1] 赵仪云[1] 阮洪江[2] 谢新敏[1] 刘华水[1] 李强[1] 赵学春[1] 

机构地区：[1]济南市第三人民医院骨科,济南250132 [2]上海交通大学附属第六人民医院骨科,上海200233

出　　处：《中国矫形外科杂志》2015年第20期1850-1853,共4页Orthopedic Journal of China

摘　　要：[目的]探讨跗骨窦切口联合经皮置钉技术微创治疗SandersⅢ型跟骨骨折的手术方法和临床疗效。[方法]2013年1月-2013年12月,采用跗骨窦切口联合经皮置钉技术微创治疗SandersⅢ型跟骨骨折32例,根据术前、术后及随访的X线片分析比较手术前后跟骨Bohler角、Gissane角改变,并于随访时按照Maryland足部评分系统对疗效进行评价。[结果]本组病例随访时间12-14个月,平均12.5个月。骨折愈合时间3-6个月,平均4.2个月。所有患者术后均无切口边缘皮肤坏死、血肿、明显的骨折再移位、腓骨肌腱炎、神经炎等并发症。术后Bohler、Gissane角与术前比较差异有统计学意义（P〈0.01）。Maryland足功能评分显示该方法治疗跟骨骨折优良率为90.6%。[结论]跗骨窦切口联合经皮置钉术具有创伤小、切口并发症少、复位固定可靠的优点,可用于治疗SandersⅢ型复杂跟骨骨折,临床疗效满意。[Objective]To investigate the clinical effects and feasibility of the sinus tarsi approach for percutaneous pedicle screw technology in treating calcaneal fractures of Sanders type Ⅲ.[Method]From January 2013 to December 2013,32 patients with intra-articular calcaneal fractures were treated with percutaneous pedicle screw through sinus tarsi approach.The Bohler angle and Gissane angle were compared before and after operation.The clinical results were evaluated with the Maryland foot score system.All data were analyzed statistically with SPSS13.0 software,in order to find the effect of this new technique.[Result]All the patients were followed up for 12 to 14 months（ mean,12.5 months）.Fracture healing time was from 3 to 6 months（ mean,4.2 months）.There was significant difference of Bohler and Gissane angle before and after surgery（ P〈0.01）.According to Maryland foot score system,an excellent and good outcome of 90.6% was achieved.[Conclusion]Sinus tarsi approach for percutaneous pedicle screw technology is an effective method for the treatment of calcaneal fractures of Sanders type Ⅲ.It has the advantages of small trauma,safe operation,less complication,stable fixation,and early ambulation.

关 键 词：跗骨窦切口 经皮置钉技术 微创治疗 跟骨骨折 

分 类 号：R687.3[医药卫生—骨科学]