闭合撬拨复位空心钉内固定治疗跟骨关节内骨折患儿的临床效果  

Effect of Closed Pry Reduction and Cannulated Nail Internal Fixation in the Treatment of Intra-articular Calcaneal Fracture in Children

作　　者：申子龙[1] 程富礼[1] SHEN Zilong;CHEN Fuli(Department of Pediatric Orthopedics,Zhengzhou Orthopedics Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州市骨科医院小儿骨科,河南郑州450052

出　　处：《河南医学研究》2021年第24期4469-4472,共4页Henan Medical Research

摘　　要：目的探究空心钉内固定(闭合撬拨复位)对跟骨关节内骨折患儿血清骨代谢的影响。方法回顾性收集2018年1月至2021年1月郑州市骨科医院收治的82例跟骨关节内骨折患儿临床资料,按手术方案分成A组(n=41)、B组(n=41)。B组接受切开复位钢板内固定(ORIF)治疗,A组接受空心钉内固定(闭合撬拨复位)治疗。对比两组术前、术后3个月Gissane、Bohler角、美国足踝外科协会(AOFAS)踝-后足功能量表评分、围术期指标、术前、术后1个月、术后3个月骨代谢指标[Ⅰ型胶原交联C端肽(sCTX)、骨形态发生蛋白(BMP-2)、骨钙素(sOC)]水平。结果术后3个月两组Gissane、Bohler角较术前改善,AOFAS评分较术前高(P<0.05),但组间对比差异无统计学意义(P>0.05);A组术中失血量较B组少,住院时长较B组短,切口长度较B组短(P<0.05);A组术后1、3个月血清sCTX水平较B组低,血清BMP-2、sOC水平较B组高(P<0.05)。结论空心钉内固定(闭合撬拨复位)治疗跟骨关节内骨折患儿效果明显,可有效优化围术期指标,提高踝足功能,促进骨折愈合。Objective To explore the effect of cannulated nail internal fixation(closed pry reduction)on serum bone metabolism in children with intra-articular calcaneal fracture.Methods A total of 82 children with intra-articular calcaneal fracture in Zhengzhou Orthopedics Hospital from January 2018 to January 2021 were retrospectively collected and divided into group A(n=41)and group B(n=41)according to different surgical procedures.Group B received open reduction plate internal fixation(ORIF),and group A received hollow nail internal fixation(closed pry reduction).Gissane,Bohler angle,American Association of Foot and Anchor Surgery(AOFAS)ankle-hindfoot function scale score,perioperative indexes,bone metabolism indexes[serum C-tenninal cross linked peptide(sCTX),bone morphogenetic protein(BMP-2)and serum osteocalcin(sOC)levels of before,1 month and 3 months after surgery were compared between the two groups.Results Three months after operation,the Gissane and Bohler angles of the two groups were improved,and the AOFAS scores were higher than those before operation(P<0.05),but there was no significant difference between the two groups(P>0.05).Compared with group B,group A had less intraoperative blood loss,shorter length of hospital stay and shorter incision length(P<0.05).The sCTX level of group A was lower than that of group B at 1 and 3 months after operation,and the serum BMP-2 and sOC levels were higher than those of group B(P<0.05).Conclusion The effect of cannulated screw internal fixation(closed prying reduction)in the treatment of children with intra-articular calcaneal fracture is obvious,which can effectively optimize the perioperative indexes,improve the ankle foot function and promote fracture healing.

关 键 词：内固定 闭合撬拨复位 跟骨 空心钉 

分 类 号：R726.8[医药卫生—儿科]