摘要
目的:探讨载距突螺钉固定术治疗SandersⅡ、Ⅲ型跟骨骨折的临床疗效。方法:2010年1月至2012年10月行切开复位内固定治疗跟骨骨折38例38足。根据Sanders分类,Ⅱ型15足,Ⅲ型23足。按固定方式不同分为两组:载距突固定组18例,男13例,女5例,年龄25-55岁,平均(38.56±8.03)岁,每例均有1枚螺钉拧入载距突;载距突未固定组20例,男16例,女4例,年龄29-53岁,平均(42.35±8.29)岁,螺钉未拧入载距突。通过两组术前、术后影像学指标的变化及术后Maryland足评分、VAS评分比较疗效。结果:38例均获随访,时间12~20个月,平均14个月。两组术后均恢复了Btihler角,重建了距下关节。术后1年Maryland足评分,载距突固定组平均88.61±7.59,载距突未固定组平均82.40±9.24,载距突固定组评分高于未固定组,足功能恢复更好。术后1年VAS评分,载距突固定组平均13.39±11.47,载距突未固定组平均22.50±13.10,载距突固定组术后VAS评分更低,足痛更少。结论:使用载距突螺钉固定术治疗SandersⅡ、Ⅲ型跟骨骨折,固定强度大,稳定性高,术后疼痛少,功能恢复更好。
Objective :To explore the clinical outcomes of open reduction and internal fixation with calcaneal locking plates in treating Sanders type Ⅱ and Ⅲ calcaneal fractures. Methods:From January 2010 and October 2012,38 calcaneal fractures with Sanders type Ⅱ or Ⅲ were treated with open reduction and internal fixation with calcaneal locking plate. According to the Sanders classification, 15 fractures were classified as type Ⅱ , 23 fractures as type Ⅲ. The patients were divided into two groups (group A and B) according to the different fixed methods. Sustentaculum tall was fixed with one screw in group A,including 13 males and 5 females,with a mean age of (38.56±8.03) years old (ranged,25 to 55 ). And sustentaculnm tali was not fixed in group B,inclnding 16 males and 4 females,with a mean age of (42.35±8.29) years old (ranged,29 to 53). Clinical effects were evaluated according to the changes of Bohler' s angle and the Maryland Foot Score and VAS score. Results :All patients were followed up from 12 to 20 months with a mean of 14 months. Bohler's angles and subtalar joints obtained satisfactory reconstruction in all patients. One year after operation ,the mean Maryland Foot Score was 88.61 ±7.59 in group A;and was 82.40±9.24 in group B; Maryland Foot Score of group A was higher and foot functional rehabilitation was better than group B. The mean VAS score was 13.39±11.47 in group A;and was 22.50± 13.10 in group B;VAS score of group A was lower and foot pain was less than group B. Conclusion: Sustentaculum tali screw fixation has advantages of strong fixed strength, high stability, less postoperative pain, rapid functional recovery in treating Sanders type Ⅱ and Ⅲ calcaneal fractures.
出处
《中国骨伤》
CAS
2015年第1期31-35,共5页
China Journal of Orthopaedics and Traumatology
关键词
跟骨
骨折
载距突
后距关节面
骨折固定术
内
Calcaneus
Fractures
Sustentaculum tall
Posterior talar articular surface
Fracture fixation,internal