有限切口螺钉绞锁内固定治疗SandersⅡ型、Ⅲ型跟骨骨折的临床观察——跟骨骨折初级次级骨折线形成机制的思考及有限切口经皮内固定治疗  

Clinical results on the treatment of sandersⅡ,Ⅲcalcaneal fracture with limited incision screw fixation--the mechanism of primary,secondary fracture line formation of calcaneus fracture and the treatment with limited incision screw fixation

作　　者：孟令兴 狄昱光 孙勇 李金元 马兴旺 常非[2] Meng Lingxing;Di Yuguang;Sun Yong;Li Jinyuan;Ma Xingwang;Chang Fei(Department of Hand and Foot Traumatology,Jilin Orthopedic Hospital,Jilin 132001,China;The Second Hospital of Jilin University,Changchun 130000,China)

机构地区：[1]吉林市骨伤医院手足创伤科,吉林吉林132001 [2]吉林大学第二医院,吉林长春130000

出　　处：《足踝外科电子杂志》2020年第3期17-21,共5页Electronic Journal of Foot and Ankle Surgery

基　　金：省科技厅科技攻关项目(20190304121YY);吉林省财政厅(3D518V353429);吉林省发展与改革委员会(2018C052-4);吉林省卫生与健康委员会(20165061)。

摘　　要：目的探讨改进固定螺钉的布局、增加固定强度的疗效。方法回顾性分析自2017年1月至2019年12月采用有限切口螺钉绞锁内固定治疗SandersⅡ型、Ⅲ型跟骨骨折病历及随访资料完整的24例(26足),对术前术后跟骨结节关节(Bohler)角进行统计学比较,采用Maryland后足功能评分系统评价临床疗效。结果随访时间6~20个月,平均12个月。患者术后Bohler角较术前有明显改善(P<0.05)。根据Maryland后足功能评分标准,优(90~100分)18例(19足),良(75~89分)4例(4足),可(50~74分)2例(3足)。所有病例切口均一期愈合,无切口并发症发生。结论有限切口螺钉绞锁固定通过独特的螺钉绞锁布局,增强了跟骨骨折特别是后关节面的固定强度,功能恢复更快更好。术前等待时间短、创伤小、并发症少。Objective To explore the effect of improving the layout of the fixation screw and increasing the fixation strength.Methods From Jan 2017 to Dec 2019,24 cases(26 feet)of Sanders typeⅡ,Ⅲcalcaneus fracture were treated with limited incision screw fixation.The Bohler angle was compared before and after operation,and the clinical effect was evaluated by the function score system of Maryland.Results Patients were followed up for 6 to 20 months,with an average of 12 months.The Bohler angle of the patients was significantly improved after operation(P<0.05).According to the criteria of Maryland's function score,18 cases(19 feet)were excellent,4 cases(4 feet)were good,and 2 cases(3 feet)were fair.All the incisions healed without complications.Conclusion Through the unique layout of screw fixation,the limited incision screw fixation can enhance the fixation strength of calcaneus fracture,especially the posterior articular surface.The functional recovery is faster and better,with short preoperative waiting time,minimal invasive and low complication rate.

关 键 词：跟骨骨折 有限切口 螺钉绞锁 

分 类 号：R683.4[医药卫生—骨科学]