经跗骨窦切口应用可吸收棒联合克氏针治疗SandersⅡ、Ⅲ型跟骨骨折的疗效分析  

Treatment of SandersⅡ&Ⅲcalcaneal fractures with an absorbable stick plus Kirschner wire through the tarsal sinus incision

作　　者：焦福德 庄云强[1] 应霁翀[1] 陈剑明[1] 刘建磊[1] 虞天明 姜刚强[1] Jiao Fude;Zhuang Yunqiang;Ying Jichong;Chen Jianming;Liu Jianlei;Yu Tianming;Jiang Gangqiang(The Third Ward of Department of Traumatic Orthopeadics,The Sixth Hospital of Ningbo,Ningbo 315040,Zhejiang,China)

机构地区：[1]宁波市第六医院创伤骨科三病区,宁波315040

出　　处：《中华创伤骨科杂志》2022年第1期73-77,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的观察经跗骨窦切口应用可吸收棒联合克氏针治疗SandersⅡ、Ⅲ型跟骨骨折的疗效。方法回顾性分析2017年7月至2020年5月宁波市第六医院创伤骨科三病区经跗骨窦切口应用可吸收棒联合克氏针治疗的37例SandersⅡ、Ⅲ型跟骨骨折患者资料。男25例,女12例;年龄(48.2±5.6)岁(20~69岁);左侧12例,右侧20例,双侧5例;跟骨Sanders分型:Ⅱ型20侧,Ⅲ型22侧。记录骨折愈合时间及并发症发生情况,比较患者术前、术后及末次随访时的B?hler角、Gissane角。术后6个月采用Morrey法评价术后患者距下关节活动度。术后12个月采用美国足踝外科协会(AOFAS)的踝-后足评分评价功能效果。结果37例患者均获随访,时间(15.2±2.7)个月(13~18个月)。所有患者均未发生切口皮肤坏死、克氏针变形或断裂、骨折复位丢失、克氏针针道感染等并发症。术后37例患者跟骨解剖形态均恢复满意,术前、术后及末次随访时的B?hler角为13.3°±1.6°、32.5°±5.5°、32.7°±5.4°,Gissane角为78.3°±6.7°、127.2°±6.7°、128.0°±6.4°,以上指标术后和末次随访时均较术前增加,差异有统计学意义(P<0.05),术后及末次随访时比较差异均无统计学意义(P>0.05)。术后6个月距下关节活动度:轻度25例,中度12例,中度以上受限率为32.4%(12/37)。术后12个月AOFAS的踝-后足评分:优12例,良21例,可4例,优良率为89.2%(33/37)。结论经跗骨窦切口应用可吸收棒联合克氏针治疗SandersⅡ、Ⅲ型跟骨骨折疗效满意。Objective To investigate the efficacy of treatment of SandersⅡ&Ⅲcalcaneal fractures with an absorbable stick plus Kirschner wire through the tarsal sinus incision.Methods From July 2017 to May 2020,37 patients with 42 SandersⅡ&Ⅲcalcaneal fractures were treated with an absorbable stick plus Kirschner wire through the tarsal sinus incision at The Third Ward of Department of Traumatic Orthopeadics,The Sixth Hospital of Ningbo.There were 25 males and 12 females,with an age of(48.2±5.6)years(from 20 to 69 years).The fractures were at the left side in 12 cases,at the right side in 20 and at bilateral sides in 5.By Sanders classification,20 fractures were typeⅡand 22 ones typeⅢ.Fracture union time and complications were recorded.Their Böhler and Gissane angles were compared between preoperation,postoperation and the last follow-up.The range of motion of the subtalar joint was evaluated by the Morrey method at 6 months postoperation.The functional recovery was evaluated by the American Society of Foot and Ankle Surgery(AOFAS)ankle-hindfoot score at 12 months postoperation.Results The 37 patients were followed up for(15.2±2.7)months(from 13 to 18 months).There were no such complications as incision skin necrosis,Kirschner wire deformation,loss of fracture reduction or Kirschner wire infection.The anatomical morphology of the calcaneus was restored satisfactorily in the 37 patients.At preoperation,postoperation and the last follow-up,the Böhler angles were 13.3°±1.6°,32.5°±5.5°and 32.7°±5.4°and the Gissane angles 78.3°±6.7°,127.2°±6.7°and 128.0°±6.4°,respectively,showing significant differences between the preoperative and postoperative values(P<0.05)but no significant differences between postoperation and the last follow-up(P>0.05).The range of motion of the subtalar joint at 6 months postoperation was slightly limited in 25 cases and moderately limited in 12 cases,giving a rate of moderate and above limitation of 32.4%(12/37).By the AOFAS ankle-hindfoot score at 12 months postoperation,1

关 键 词：跟骨 骨折 骨折固定术 内 跗骨窦 

分 类 号：R687.3[医药卫生—骨科学]