戴氏伤科特色疗法治疗闭合性跟骨骨折  

Treatment of Closed Calcaneal Fractures with Special Treatment of Dai's Department of Injury

作　　者：戴俭华[1] 黄平[1] 金永翔[1] 周晨[1] 吴刚 DAI Jianhua;HUANG Ping;JINY Yongxiang;ZHOU Cheng;WU Gang(Wuhu Hospital of Traditional Chinese Medicine,Wuhu City,Anhui Province 241000 China)

机构地区：[1]安徽省芜湖市中医医院,芜湖市戴氏骨伤研究所,安徽芜湖241000

出　　处：《中医药临床杂志》2020年第8期1453-1456,共4页Clinical Journal of Traditional Chinese Medicine

基　　金：2016年全国名老中医药专家传承工作室建设项目(国中医药人教发[2016]42号)。

摘　　要：目的:评估手法复位、杉树皮小夹板结合纸压垫外固定治疗闭合性跟骨骨折的临床疗效。方法:采用该疗法对我院2014年3月~2016年10月入院的38例闭合性单足跟骨骨折病人进行治疗并随访,分别测量复位前及复位后12周跟骨宽度、Böhler角及Gissane角的数值,并在伤后12个月对患足行Maryland足部评分。结果:38例患者均获得随访,随访时间12~17(13.5±1.4)个月。患者骨折均正常愈合,愈合时间8~11(9.5±0.7)周。其中跟骨宽度由复位前的(35.2±2.7)mm降至复位后12周(30.1±1.9)mm,二者比较差异有统计学意义(P<0.05)。Böhler角由复位前的(15.3±3.1)°增加至复位后12周(29.7±4.8)°,二者比较差异有统计学意义(P<0.05)。Gissane角由复位前的(134.7±9.0)°降至复位后12周(119.8±8.3)°,二者比较差异有统计学意义(P<0.05)。伤后12个月Maryland足部评分为(85.1±2.6)分,其中优11例,良21例,可5例,差1例,优良率84.2%。结论:采用戴氏伤科特色的手法复位、杉树皮小夹板结合纸压垫外固定治疗闭合性跟骨骨折具有创伤小、费用低等优点,疗效确切,适用于具有开放手术禁忌症的跟骨骨折患者;对于具有开放手术指征,但保守治疗意愿强烈的患者,也可选择使用。jective:To evaluate the clinical efficacy of manual reduction,cedar bark splint combined with paper pressure pad external fixation in the treatment of closed calcaneal fractures.Methods:38 cases of closed single calcaneal fracture patients admitted to our hospital from March 2014 to October 2016 were treated with this therapy and followed up.The calcaneal width,Böhler angle and Böhler angle were measured before and 12 weeks after reduction.The value of Gissane’s angle and the Maryland foot score for the affected foot 12 months after injury.Results:All 38 patients were followed up for 12-17(13.5±1.4)months.The fractures of the patients healed normally and the healing time was 8-11(9.5±0.7)weeks.The width of the calcaneus decreased from 35.2±2.7mm before reduction to 30.1±1.9mm at 12 weeks after reduction.The difference between the two was statistically significant(P<0.05).The Böhler angle increased from 15.3±3.1°before reduction to 29.7±4.8°12 weeks after reduction,and the difference between the two was statistically significant(P<0.05).The Gissane angle decreased from 134.7±9.0°before reduction to 119.8±8.3°12 weeks after reduction,and the difference between the two was statistically significant(P<0.05).The Maryland foot score at 12 months after injury was 85.1±2.6 points,of which 11 cases were excellent,21 cases were good,5 cases were fair,and 1 case was poor.The excellent and good rate was 84.2%.Conclusion:The treatment of closed calcaneal fractures with Dai’s Traumatology characteristic manual reduction,cedar bark splint combined with paper pressure pad external fixation has the advantages of less trauma,low cost,etc.,and the curative effect is accurate.It is suitable for heels with contraindications to open surgery.Patients with bone fractures;patients who have indications for open surgery but are willing to treat conservatively can also choose to use it.

关 键 词：戴氏伤科 闭合性跟骨骨折 手法复位 外固定 

分 类 号：R683[医药卫生—骨科学]