跗骨窦入路空心钉固定术治疗SandersⅡ型跟骨骨折分析  

Tarsal Sinus Approach Cannulated Screw Fixation Treatment SandersⅡType Analysis of Calcaneal Fractures

作　　者：季鹏飞 JI Peng-fei(Department of Orthopedics,Qihe County People’s Hospital,Shandong Dezhou 251100)

机构地区：[1]齐河县人民医院骨外科,山东德州251100

出　　处：《中国医疗器械信息》2021年第12期7-8,16,共3页China Medical Device Information

摘　　要：目的:对空心螺钉跗骨窦入路内固定方法治疗跟骨SandersⅡ型骨折的临床应用方法及其价值进行分析。方法:将40例跟骨骨折患者作为研究对象,所有患者均给予经载距突空心螺钉附骨窦入路进行内固定方法治疗,40例患者中女性16例,男性24例;年龄20~59岁,平均(46.33±0.58)岁;其中32例脚跟左侧骨折,8例脚跟右侧骨折;依据Sanders分型分为:20例ⅡA型,20例ⅡB型。分别对患者术前及术后的Gissane角、B6hler角进行观察和记录,对关节面的恢复情况进行评估和判定。依据Maryland足部评分标准(美国足踝外科协会)对足部功能的恢复情况进行评估。结果:治疗结束后对所有患者开展6~12个月的随访,骨折均得到愈合,愈合时间为7.5~12周,平均(9.6±2.1)周,患足切口均未发生并发症。Gissane角术前平均为(96.0˚±3.8˚),术后平均为(124.9˚±10.8˚),Bohler角术前平均为(15.6˚±2.3˚),术后平均为(30.5˚±2.9˚);术后的Gissane角和Bohler角状况均明显优于治疗前(P<0.05)。Maryland足部评分结果为:26例为优秀,8例为良好,4例为尚可,2例为较差,足部恢复优良率为95.0%。结论:应用空心螺钉跗骨窦入路内固定方法治疗跟骨SandersⅡ型骨折,临床效果较为满意,术中组织剥离较少,有利于跟距关节面平整度的恢复,在Bohler角、Gissane角及跟骨的宽度方面恢复情况良好。Objective:The application of hollow screw tarsal sinus approach fixation method to treat calcaneal SandersⅡclinical application method of the fracture analysis and its application value.Methods:40 patients with calcaneal fractures were selected as the research objects.All patients were treated with internal fixation via the hollow screw attached to the bone sinus via the loading talus process.Among the 40 patients,16 were female and 24 were male.The age ranged from 20 to 59(46.33±0.58)years.There were 32 cases of left heel fracture and 8 cases of right heel fracture.According to the Sanders classification can be divided into:20 cases ofⅡtype A,20 casesⅡtype B.The Gissane angle and B6hler angle of the patient were observed and recorded before and after surgery,respectively,and the recovery of articular surface was evaluated and determined.Recovery of foot function is evaluated based on the American Association of Foot and Ankle Surgeons Maryland Podiatric Score.Results:All patients were followed up for 6~12 months after the end of treatment,and the fracture healing time was 7.5~12(9.6±2.1)weeks.No complications occurred in the affected foot incision.The preoperative and postoperative averages of Gissane angles were(96.0˚±3.8˚),(124.9˚±10.8˚),(15.6˚±2.3˚),and(30.5˚±2.9˚).After operation,the condition of Gissane angle and Bohler angle were significantly better than before treatment(P<0.05).In Maryland,26 cases were excellent,8 cases were good,4 cases were fair,and 2 cases were poor.The rate of good and excellent foot recovery was 95.0%.Conclusion:The application of hollow screw tarsal sinus approach fixation method to treat calcaneal SandersⅡtype fracture,obtained satisfactory clinical effect,less intraoperative tissue,from help with the recovery of joint surface roughness,the Bohler angle,Gissane angle and the width of the heel bone recovering well.

关 键 词：根骨骨折 外科手术 空心螺钉 内固定 

分 类 号：R687.3[医药卫生—骨科学]