外侧小切口有限内固定治疗关节内跟骨骨折  

The Iateral Small Incision Combined with Limited Internal Fixation in Treatment of Intra-articular Calcaneal Fractures

作　　者：顾怀增 文明[1] 曾超[1] 冯云华[1] 王景彦[1] 

机构地区：[1]潍坊市中医院手足骨科,山东潍坊261041

出　　处：《潍坊医学院学报》2016年第3期209-211,共3页Acta Academiae Medicinae Weifang

摘　　要：目的观察跟骨外侧小切口有限内固定结合跟距反牵器外固定治疗关节内跟骨骨折的疗效。方法选取2003年4月~2014年2月55例62足关节内跟骨骨折的患者,采用自行设计的跟骨外侧小切口入路复位后加横向螺钉固定,结合跟距反牵复位器外固定治疗,术后参照美国骨科足与踝关节协会（AOFAS）的足踝临床评分系统进行综合评分;记录切口愈合情况;对比术前术后Bohler＇s角、Gissane角和跟骨宽度的变化并进行统计学分析。结果术后所有患者均获得随访,根据AOFAS评分标准系统：本组55例62足优24足,良31足,可7足,优良率88.7%.术后切口均甲级愈合,未出现裂开、皮缘坏死及感染。X线片显示术后跟骨Bohler＇s角、Gissane角及跟骨宽度均获得满意恢复,手术效果满意。结论跟骨外侧小切口可同时清晰显露跟骨外侧壁和后距下关节面,结合有限固定治疗关节内跟骨骨折创伤小,复位效果好,并发症少,是治疗关节面移位的跟骨骨折的一种良好选择。Objective To observe the curative effect through lateral small incision and limited internal fixation combined with reverse traction and external fixation instrument between calcaneal and talus in the treatment of intraarticular calcaneal fractures. Methods Fifty-five cases（ with 62 feet） of intra-articular calcaneal fractures were collected from Apr. 2008 to Feb. 2016 in our department. Restoration and transverse screw fixation were executed by using self-designed calcaneal lateral small incision,combined with reverse traction and external fixation instrument between calcaneal and talus. Referring to the American orthopaedic foot and ankle society（ AOFAS） foot and ankle scoring criteria to score and record the healing of the incision. Bohler＇s angle,Gissane angle,the width of the calcaneus preoperative and postoperative were also adopted to the statistic analysis. Results All patients were followed-up according to AOFAS scoring criteria,24 feet were excellent,31 feet were good,7 feet were fair,produced an excellent and good rate of 88. 7%. No case skin edges superficial necrosis. Bohler＇s angle,Gissane angle,the width of the calcaneus all got satisfactory recovery in the X-ray. Conclusion It is a good way to choose the lateral small incision which can appear the paries lateralis of the calcaneus clearly and combine with limited internal fixation in curing intra-articular calcaneal fractures,by this method it can get a good consequence with small trauma and little complication.

关 键 词：外侧小切口 跟骨 关节内骨折 

分 类 号：R683.42[医药卫生—骨科学]