撑开器双向撑开辅助闭合复位微创接骨板内固定治疗跟骨骨折  

Treatment of calcaneal fracture by closed reduction and minimally invasive plate fixation assisted with bidirectional distractor distraction

作　　者：桑庆华[1] 哈秀民[1] 姜佩瑜 张晓光 李东亮[1] 张世虎 SANG Qing-hua;HA Xiu-ming;JIANG Pei-yu;ZHANG Xiao-guang;LI Dong-liang;and ZHANG Shi-hu(Department of Orthopaedics,Beijing Yanqing County Hospital（Peking University Third Hospital Yanqing Hospital）,Bei-jing 102100,China)

机构地区：[1]北京市延庆区医院北京大学第三医院延庆医院骨科,北京102100

出　　处：《中国骨伤》2018年第7期604-607,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨撑开器双向撑开跟骨骨折闭合复位微创接骨板内固定治疗跟骨骨折的临床疗效。方法 :自2015年9月至2016年10月,采用撑开器双向撑开辅助闭合复位微创接骨板内固定治疗11例(13足)跟骨骨折,全部为男性,年龄24～57岁,平均36.4岁。Sanders分型:Ⅱ型8足,Ⅲ型5足。术后观察切口情况、骨折愈合情况、B?hler角、Gissane角及采用Maryland足部评分系统进行功能评价。结果:所有骨折愈合,无切口感染或切口不愈合的并发症发生。所有患者术后获得随访,时间12～15个月,平均13.5个月。跟骨B?hler角由术前的(9.6±7.3)°恢复至术后1年的(20.2±4.6)°,差异有统计学意义;跟骨Gissane角由术前的(92.7±8.5)°恢复至术后1年的(121.7±7.6)°,差异有统计学意义。术后1年Maryland足部评分为88.79±8.25,优11足,良2足。结论:撑开器双向撑开跟骨骨折闭合复位微创接骨板内固定可以有效固定骨折,减少切口并发症,术后随访影像及功能满意,是治疗SandersⅡ、Ⅲ型跟骨骨折的有效方法之一。Objective：To investigate clinical effects of calcaneal fracture with closed reduction and minimally invasive plate fixation assisted with bidirectional distractor distraction. Methods：From September 2015 to October 2016,11 male patients（13 feet） with calcaneal fractures treated with bidirectional distractor distraction assisted with minimally invasive plate fixation were retrospectively studied. They were aged from 24 to 57 years old with an average of 36.4 years old;8 feet were typeⅡand 5 feet were type Ⅲ according to Sanders classification. Postoperative incision,fracture healing,B？hler angle,Gissane angle were observed and Maryland scoring system was used to evaluate clinical effects. Results：All fractures healed well without incision inflammation and incision disunion. All patients were followed up from 12 to 15 months with an average of 13.5 months. B？hler angle were improved from（9.6±7.3）° before operation to（20.2±4.6） ° at 1 year after operation,and had statistical meaning; Gissane angle increased from（92.7 ± 8.5）° before operation to（121.7 ±7.6） ° at 1 year after operation. Maryland score at 1 year after operation was 88.79±8.25,and 11 feet got excellent results and 2 feet moderate. Conclusion：Bidirectional distractor distraction assisted with minimally invasive plate fixation could effectively fix calcaneal fractures,reduce postoperative complications,and get satisfied results of postoperative images and functional recovery. It is one of effective methods for treating Sanders Ⅱ and Ⅲ calcaneal fractures.

关 键 词：跟骨 微创外科手术 骨折固定术 内 骨折闭合复位 

分 类 号：R687.3[医药卫生—骨科学]