跗骨窦入路低切迹锁定钢板治疗复杂跟骨关节内骨折的临床效果  

Clinical effect of low-profile locking plate via tarsal sinus approach on complicated intra-articular calcaneal fracture

作　　者：李广伟[1] 董斌[1] 白忠旭[1] 孟松桥 Li Guangwei;Dong Bin;Bai Zhongxu;Meng Songqiao(Department of Orthopaedics and Traumatology^the Second People’s Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]郑州市第二人民医院骨科创伤科,450000

出　　处：《临床医学》2021年第6期7-10,共4页Clinical Medicine

摘　　要：目的探讨跗骨窦入路低切迹锁定钢板治疗复杂跟骨关节内骨折的临床效果。方法选取郑州市第二人民医院2016年6月至2019年6月收治的31例35足SandersⅡ、Ⅲ、Ⅳ型跟骨闭合骨折患者,采用跗骨窦入路低切迹锁定钢板内固定治疗,进行长期随访,通过X线测量术前、术后Bohler’s角并进行比较,采用Maryland足部评分系统判定足部功能优良率。结果随访时间12~48个月,平均23个月。术后复查跟骨侧位和轴位线片,跟骨高度、长度及宽度均较术前恢复,差异有统计学意义(P<0.05)。解剖形态恢复满意,Bohler’s角恢复到(31.9±3.5)°,差异有统计学意义(P<0.05)。手术治疗31例35足,优26足,良4足,可3足,差2足,患足术后的功能优良率为85.7%(30/35)。结论复杂的跟骨骨折均应采取手术处理,使用低切迹跟骨锁定钛钢板治疗SandersⅡ、Ⅲ、Ⅳ型跟骨骨折,能够减少并发症,最大限度保留患足功能,疗效确切。Objective To investigate the clinical effect of low-profile locking plate via tarsal sinus approach on complicated intra-articular calcaneal fractures.Methods From June 2016 to June2019,31 cases of SandersⅡ,Ⅲ,Ⅳcalcaneal closed fractures in 35 feet were treated with locking plate internal fixation via tarsal sinus approach.The patients were followed up for a long time.The preoperative and postoperative Bohler’s angles were measured by X-ray and compared.Maryland foot score system was used to determine the excellent and good rate of foot function.Results The follow-up time was 12-48 months,with an average of 23 months.The height,length and width of calcaneus were recovered after operation,with significant differences(P<0.05).The average recovery of Bohler’s angle was 31.9°,with significant difference(P<0.05).Thirty five feet of 31 patients were treated surgically,26 feet were excellent,4 feet were good,3 feet were fair,and 2 feet were poor.The excellent and good rate of function was 85.7%(30/35).Conclusions Complicated calcaneal fractures should be treated by operation.The use of low-profile calcaneal locking plate in the treatment of Sanders typeⅡ,Ⅲ,Ⅳcalcaneal fractures can reduce complications,maximize the function of the affected foot,and has definite curative effect.

关 键 词：跟骨骨折 跗骨窦手术入路 低切迹锁定钢板 内固定 

分 类 号：R687.3[医药卫生—骨科学]