期刊文献+

锁定加压钛板内固定治疗跟骨骨折 被引量:40

Application of locking compression plate in treatment of calcaneal fractures
原文传递
导出
摘要 目的探讨应用锁定加压钛板内固定治疗跟骨骨折的临床疗效。方法2008年1月至2011年12月收治并获得随访的跟骨移位的关节内骨折30例(40足),男25例(33足),女5例(7足);年龄22-60岁,平均44.8岁。左侧15足,右侧25足;均为闭合性骨折,2例合并脊柱损伤。根据跟骨骨折SandeⅠ分型,Ⅱ型20足,Ⅲ型15足,Ⅳ型5足。手术均采用跟骨外侧扩大“L”形切口,骨折复位后以锁定加压钛板固定。术后不予石膏外固定,早期行踝关节功能练习,术后6周部分负重,12周完全负重。采用美国足踝外科协会(AmericanOrthopaedicFoot&AnkleSociety,AOFAS)踝与后足功能评分评价足踝功能。结果随访时间8-20个月,平均12个月。骨折愈合时间8-12周,平均10周。无延迟愈合、神经损伤及骨髓炎病例。l例出现切口裂开及部分钛板螺钉外露,经换药1个月后切口逐渐愈合。2例术后出现距下关节创伤性关节炎,行走时疼痛,其中l例行距下关节融合术后疼痛消失,另1例因经济原因拒绝行进一步治疗后失去随访。末次随访时AOFAS踝与后足功能评分结果为优20足、良17足、可3足,优良率92.5%(37/40)。结论应用锁定加压钛板内固定治疗跟骨骨折有利于早期愈合和功能锻炼,术后软组织并发症发生率低。 Objective To evaluate the clinical effect of the treatment for calcaneal fractures by locking compression plate. Methods From January 2008 to December 2011, 30 patients with 40 calcaneal fractures were operated with locking compression plate. There were 25 males (33 feet) and 5 females (7 feet) with an average age of 44.8 years (range, 22-60 years). Fifteen feet were on the left side, and 25 feet were on the right side. All patients had closed fractures, with complicated spinal injury in 2 patients. According to Sanders classification, 20 feet were type Ⅱ fractures, 15 feet were type Ⅲ, and 5 feet were type IV. The lat- eral approach was adopted for all the patients in the treatment in which locking compression plate fixation was used but no external fixation. Early and suitable rehabilitation was carried out postoperatively. The pa- tients could bear part of the loading six weeks after the operation and all the loading twelve weeks after the operation. The results were validated using the American Orthopaedic Foot and Ankle Society (AOFAS) an- kle-hindfoot scale. Results The patients were followed up for 8-20 months (average, 12 months). Bone u- nion occurred in all cases with roentgenographic evidence during 8-12 weeks postoperation (average, 10 weeks). None of the patients had such complications as nerve injury or osteomyelitis. Incision dehiscence oc- curred in one case in which a little part of titanium plate and screw was exposed, but the incision was healed by dressing 1 month later. Two patients had subtalar arthritis and suffered from the pain while walking. Of the two patients, the pain was relieved for one after the operation of subtalar joint fusion, and the other was lost to the follow-up after he or she refused further treatment for economic reasons. According to AOFAS foot score standard, the effects of 20 cases were excellent, 17 were good, and 3 were fair. The excellent and good rate was 92.5%. Conclusion The application of locking compression plate is an effective and satisfied treatment of calcaneal fractures which is beneficial for healing and functional exercise. Moreover, the rate of soft tissue complication after operation is low.
出处 《中华骨科杂志》 CAS CSCD 北大核心 2013年第4期315-319,共5页 Chinese Journal of Orthopaedics
关键词 跟骨 骨折 内固定器 Calcaneus Fractures Internal fixators Titanium
  • 相关文献

参考文献14

  • 1韩明建,王志杰,邹云雯,褚言琛.锁定跟骨钢板治疗新鲜跟骨骨折[J].中华骨科杂志,2011,31(4):335-338. 被引量:44
  • 2Bemstein J, Ahn J. In brief: Fractures in brief: calcaneal frac- tures. Cliu Ortbop Relat Res, 2010, 468(12): 3432-3434.
  • 3Sanders R. Displaced iutra-articular fractures of the calcaneus. J Bone Joint Surg Am, 2000, 82(2): 225-250.
  • 4Brauer CA, Manns BJ, Ko M, et al. An economic evaluation of operative compared with nonoperative management of displaced intra-articular calcaneal fractures. J Bone Joint Surg Am, 2005, 87(12): 2741-2749.
  • 5校佰平,李明,王邦荣,周龙,俞怡辉,王庆,魏军渔.跟骨骨折钢板内固定手术中存在的问题及对策[J].中国骨伤,2009,22(12):897-898. 被引量:10
  • 6梅炯,俞光荣,朱辉,祝晓忠,李广君,黎之挺.跟骨载距突的解剖特点及其临床意义[J].中国临床解剖学杂志,2002,20(1):9-11. 被引量:90
  • 7潘永太,许世建,郑文忠,肖奕增,黄春福,张秋林,王秋根.关节内跟骨骨折内固定治疗与并发症[J].中国矫形外科杂志,2005,13(22):1715-1717. 被引量:47
  • 8Di Schino M, Bens~ffda M, Vandenbussche E, et open reduction and cortico-cancellous autograft of calcaneal fractures according to Palmer. Rev Reparatrice Appar Mot, 2008, 94(2): 135-144. al. Results of intra-articular.
  • 9Sanders R. Intra-articular fractures of the calcaneus: present state of the art. J Orthop Trauma, 1992, 6(2): 252-265.
  • 10Cavadas PC, Landin L. Management of soft-tissue complications of the lateral approach for ca|canea! fractures. Plast Reconstr Surg, 2007, 120(2): 459-466.

二级参考文献79

共引文献621

同被引文献299

引证文献40

二级引证文献194

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部