正骨手法联合经皮撬拨复位克氏针内固定治疗SandersⅡ-Ⅲ型跟骨骨折  

Orthopedic manipulation combined with percutaneous reduction and Kirschner wire internal fixation for Sanders typeⅡandⅢcalcaneal fractures

作　　者：戴锋[1] 刘锦涛[1] 张志刚[1] 沈学强[1] 吴黎明 俞鹏飞[1] 姜宏[1] DAI Feng;LIU Jin-tao;ZHANG Zhi-gang;SHEN Xue-qiang;WU Li-ming;YU Peng-fei;JIANG Hong(Department of Orthopaedics,Suzhou TCM Hospital Affiliated to Nanjing University of Traditional Chinese Medicine,Suzhou215001,Jiangsu,China)

机构地区：[1]南京中医药大学苏州附属医院骨伤科,江苏苏州215001

出　　处：《中国骨伤》2025年第3期306-310,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨正骨手法联合撬拨复位克氏针内固定治疗的SandersⅡ-Ⅲ型跟骨骨折的临床疗效。方法:回顾性分析2017年7月至2019年7月采用正骨手法联合撬拨复位克氏针内固定治疗的52例(足)SandersⅡ、Ⅲ型跟骨骨折患者的临床资料,男43例,女9例;年龄31~72(50.83±10.48)岁;SandersⅡ型15例,Ⅲ型37例。比较术前和术后24个月Böhler角、Gissane角、跟骨宽度和跟骨高度的变化情况,并采用Maryland足部功能评分进行临床疗效评价。结果:所有患者获得随访,时间24~60(41.50±9.86)个月。所有患者骨折正常愈合,愈合时间(11.00±0.95)周;Böhler角、Gissane角、跟骨宽度、跟骨高度分别由术前的(16.37±8.36)°、(96.27±9.62)°、(46.82±4.67)mm、(38.41±3.58)mm提高至术后24个月时的(31.48±8.24)°、(111.62±8.69)°、(42.06±4.83)mm、(44.21±3.82)mm,差异有统计学意义(P<0.01)。术后24个月Maryland评分为(93.04±8.83)分,其中优40例,良7例,可5例。结论:正骨手法联合撬拨复位克氏针内固定术治疗SandersⅡ、Ⅲ型跟骨骨折,可以明显改善跟骨的Böhler角、Gissane角、宽度和高度,疗效满意。Objective To explore clinical effects of bone setting manipulation combined with pry reduction and Kirschner needle internal fixation in treating SandersⅡ-Ⅲcalcaneal fracture.Methods Clinical data of 52 patients with types SandersⅡandⅢcalcaneal fracture(foot)treated with bone-setting manipulation combined with pry reduction and Kirscher needle internal fixation from July 2017 to July 2019 were retrospectively analyzed,including 43 males and 9 females,aged from 31 to 72 years old with an average of(50.83±10.48)years old;15 patients with Sanders typeⅡand 37 patients with Sanders typeⅢ.The changes of Böhler angle,Gissane angle,calcaneus width and calcaneus height before operation and 24 months after operation were compared,and Maryland foot function score was performed to evaluate clinical effects.Results All patients were followed up from 24 to 60 months with an average of(41.50±9.86)months.The fracture healed normally and the healing time was(11.00±0.95)weeks.Böhler angle,Gissane angle,calcaneal bone width and calcaneal bone height were increased from(16.37±8.36)°,(96.27±9.62)°,(46.82±4.67)mm,(38.41±3.58)mm before operation to(31.48±8.24)°,(111.62±8.69)°,(42.06±4.83)mm,(44.21±3.82)mm at 24 months after operation,and the difference were statistically significant(P<0.01).Postoperative Maryland score at 24 months was(93.04±8.83),40 patients got excellent result,7 good and 5 fair.Conclusion Orthopedic manipulation combined with percutaneous reduction and Kirschner wire internal fixation could significantly improve Böhler angle,Gissane angle,width,and height of Sanders typeⅡandⅢcalcaneal fractures,and the curative effect is satisfactory.

关 键 词：跟骨骨折 正骨手法 经皮撬拨复位 骨折内固定 中西医结合 

分 类 号：R274.12[医药卫生—中医骨伤科学]