切开复位空心螺钉结合锚钉固定术治疗糖尿病合并跟骨结节撕脱骨折的疗效观察  

Curative Effect of Open Reduction Hollow Screw Combined With Anchor Fixation in the Treatment of Diabetic Patients With Avulsion Fracture of Calcaneal Tubercle

作　　者：韩聚川[1] 王焱[1] 彭吉剑 HAN Juchuan;WANG Yan;PENG Jijian(Department of Orthopedics,Beijing Fengtai Hospital,Beijing 100071,China)

机构地区：[1]北京丰台医院骨科,北京100071

出　　处：《中国卫生标准管理》2024年第13期112-115,共4页China Health Standard Management

摘　　要：目的探讨糖尿病合并跟骨结节撕脱性骨折患者实施切开复位空心螺钉结合锚钉固定术(open reduction and internal fixation,ORIF)的效果。方法回顾性研究2020年8月—2022年4月北京丰台医院收治的22例糖尿病合并跟骨结节撕脱性骨折的患者,采用切开复位空心螺钉结合锚钉固定术治疗。围手术期及术后进行血糖的评估;术后随访使用足踝关节预后评分(foot and ankle outcome score,FAOS)、视觉模拟量表(visual analogue scale,VAS)、单脚跟抬高测试和X射线图像进行评估。结果所有骨折均在解剖位置愈合,没有出现术后固定失败、内固定松动移位以及皮肤感染、坏死等情况。术后随访6~8个月,所有患者都恢复了完全的足底屈曲范围和力量,没有步态异常或负重限制。FAOS评分:疼痛(80.85±6.20)分,症状(79.85±4.90)分,日常生活(72.35±8.00)分,运动和娱乐功能(68.25±11.93)分,足踝活动影响(77.47±6.70)分。VAS评分为(2.16±0.30)分。结论切开复位空心螺钉结合锚钉固定术是治疗糖尿病相关跟骨结节撕脱性骨折的有效手段,并显示出良好的功能和影像学结果。Objective To explore the surgical effect of cannulated screw combined with anchor in the treatment of diabetes-related calcaneal tubercle avulsion fracture.Methods From August 2020 to April 2022,a total of 12 patients with avulsion fracture of calcaneal tuberosity and diabetes mellitus iabetes patients with avulsion fracture of calcaneal tubercle admitted to Beijing Fengtai Hospital were retrospectively studied.Cannulated screw fracture reduction and internal fixation combined with anchor Achilles tenodesis were used for treatment.Postoperative follow-up was assessed using the foot and ankle outcome score(FAOS),visual analog scale(VAS),single heel raise test,and X-ray images.Results All fractures healed in anatomical position.There were no postoperative fixation failures,loosening and displacement of internal fixation,skin infection,or necrosis.All patients regained full plantar flexion range and strength at 6-8 months postoperative follow-up,without gait abnormalities or weight-bearing limitations.FAOS:pain(80.85±6.20)points,symptoms(79.85±4.90)points,activities of daily living(72.35±8.00)points,sports and recreational function(68.25±11.93)points,foot and ankle activities impact(77.47±6.70)points.VAS score was(2.16±0.30)points.Conclusion Open reduction with hollow screw combined with anchor fixation is an effective method for the treatment of diabetes-related avulsion fracture of calcaneal tubercle,and has shown good functional and imaging results.

关 键 词：跟骨结节 撕脱性骨折 内固定 糖尿病 FAOS VAS评分 

分 类 号：R681[医药卫生—骨科学]