摘要
目的 探讨闭合复位微创接骨板内固定治疗跟骨骨折的疗效.方法 对2011年11月至2013年10月采用闭合复位微创接骨板内固定治疗的37例（39足）跟骨骨折患者资料进行回顾性研究,年龄22 ～ 64岁,平均38.3岁;男33例,女4例.骨折根据Sanders分型：Ⅱ型6足,Ⅲ型25足,Ⅳ型8足.手术采用跟骨牵引结合克氏针撬拨复位的方式闭合复位,微创小切口经皮置入接骨板和螺钉治疗跟骨骨折. 结果 所有患者术后获12 ～ 24个月（平均16.5个月）随访.所有骨折均愈合,无切口感染或切口不愈合的并发症发生.跟骨B（o）hler角由术前平均8.6°±7.3°恢复至末次随访时21.2°±6.4°,差异有统计学意义（t=-14.221,P=0.000）;跟骨Gissane角由术前平均93.5°±8.5°恢复至末次随访时123.9°±8.1°,差异有统计学意义（t=-23.731,P=0.000）.使用Maryland足部评分系统评价术后功能恢复情况：优14足,良l9足,可6足,优良率为84.6％. 结论 闭合复位微创接骨板内固定治疗跟骨骨折可以取得满意的临床疗效.
Objective To analyze the treatment of calcaneal fractures with closed reduction and internal fixation with minimally invasive percutaneous plate osteosynthesis （MIPPO）.Methods From November 2011 to October 2013,37 cases （39 feet） of calcaneal fractures were treated at our department with closed reduction and MIPPO internal fixation.They were 33 men and 4 women,from 22 to 64 years of age （average,38.3 years）.According to Sander＇s classification,6 feet were type Ⅱ][,25 feet type Ⅲ,and 8 feet type Ⅳ.Closed reduction was performed by calcaneal traction and percutaneous leverage with K wires.A plate was inserted percutaneously through a small incision to fix the fracture and screws were inserted through stab incisions.Results All cases were followed up for an average of 16.5 months （from 12 to 24 months）.all fractures healed with no complications like incision infection or poor healing.The average B（o）hler＇s angle was significantly improved from preoperative 8.6°± 7.3° to 21.2°± 6.4° at the last follow-up （t =-14.221,P =0.000）; the average Gissane＇s angle was significantly improved from preoperative 93.5° ± 8.5° to 123.9° ± 8.1 ° at the last follow-up （t =-23.731,P =0.000）.The outcomes were evaluated using Maryland Foot Score,resulting in an excellent to good rate of 84.6%,with 14 excellent feet,19 good feet and 6 fair feet.Conclusion Treatment of calcaneal fractures with closed reduction and MIPPO internal fixation can achieve satisfactory outcomes.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2015年第3期238-242,共5页
Chinese Journal of Orthopaedic Trauma
关键词
跟骨
骨折
骨折固定术
内
骨板
Calcaneus
Fractures,bones
Fracture fixation,internal
Bone plate
