经皮撬拨配合有限切开植骨内固定治疗跟骨骨折疗效分析  

Percutaneous poking reduction with bone grafting and limited internal fixation for the treatment of calcaneal fractures

作　　者：陈华[1,2] 李宇卫[2] 姜宏[2] 张志刚[2] 陆斌杰[2] 

机构地区：[1]南京中医药大学,江苏南京210023 [2]南京中医药大学附属苏州医院骨科,江苏苏州215009

出　　处：《中国骨伤》2017年第12期1084-1090,共7页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨经皮撬拨配合有限切开植骨内固定治疗跟骨骨折的临床疗效。方法:自2013年5月至2016年10月收集53例单侧闭合跟骨骨折患者,分别采用闭合撬拨配合有限切开植骨(治疗组)和切开复位钢板内固定(对照组)治疗。治疗组33例,男25例,女8例,年龄15~82(44.7±14.2)岁;根据Sanders分型:Ⅱ型17例,Ⅲ型16例;对照组20例,均为男性,年龄25~62(42.2±11.3)岁,根据Sanders分型:Ⅱ型8例,Ⅲ型12例。观察并比较两组患者手术前后影像学指标的变化、住院时间、术前等待时间,末次随访时采用Maryland评分进行足部功能评价。结果:53例患者均获得随访,治疗组随访时间8~40(19.9±7.2)个月;对照组随访时间12~40(21.7±7.7)个月,差异无统计学意义(P>0.05)。术后两组间B?hler角及Gissane角比较差异无统计学意义(P>0.05);两组患者住院时间和术前等待时间比较差异有统计学意义(P<0.01);末次随访时两组Maryland评分分别为90.45±5.76和89.10±6.16,差异无统计学意义(P>0.05)。结论:经皮撬拔复位配合有限切开植骨内固定治疗跟骨骨折的临床疗效满意,创伤小,并发症少,功能恢复快。Objective：To investigate clinical effects of percutaneous poking reduction with bone grafting and limited internal fixation for the treatment of calcaneal fractures. Methods：From May 2013 to October 2016,53 patients with closed calcaneal fractures were analyzed,and were divided into treatment group and control group. There were 33 patients in treatment group including 25 males and 8 females,aged from 15 to 82 years old with an average of（44.7±14.2） years old;17 cases were type Ⅱ and 16 cases were type Ⅲ according to Sanders classification; treated by percutaneous poking reduction with bone grafting and limited internal fixation. There were 33 patients in control group,including 20 males aged from 25 to 62 years old with an average of（42.2±11.3） years old;8 cases were typeⅡand 12 cases were type Ⅲ according to Sanders classification;treated by open reduction and internal fixation. Imaging indicators,hospital stays and preoperative waiting time were observed and compared,Maryland scoring were applied to evaluate foot function. Results：Fifty-three patients were followed up,and treatment group was followed up from 8 to 40 months with an average of（19.9±7.2） months;while control group was followed up from 12 to 40 months with an average of（21.7±7.7） months,and there were not significant differences between two groups in follow-up time（ P〈0.05）. There were no obvious meaning in B？hler angles,Gissane angles between two groups（P0.05）.There were significant differences in hospital stays and preoperative waiting time（P〈0.01）. There were no significant differences in Maryland score between treatment group（90.45±5.76） and control group（89.10±6.16）. Conclusion：Percutaneous poking reduction with bone grafting and limited internal fixation for the treatment of calcaneal fractures could obtain satisfied effects,and has advantages of less trauma and complications,rapid recovery and good clinical effects.

关 键 词：跟骨 骨折 骨折固定术 内 

分 类 号：R683.42[医药卫生—骨科学]