摘要
目的：探讨应用有限内固定（克氏针、空心钉）治疗GustiloⅠ～Ⅲ型开放性跟骨骨折的方法及其疗效。方法对17例（男性15例，女性2例；年龄23～64岁，平均43.5岁） GustiloⅠ～Ⅲ型开放性跟骨骨折患者应用有限内固定治疗，观察伤口愈合及治疗前后B？hler角、Gissane角恢复情况。结果17例创面均愈合，有4例发生创面软组织缺损，经过皮瓣修复覆盖伤口愈合。全部患者随访6～12个月，平均10个月，复位无丢失，骨折均愈合。按Maryland足功能评价优11例，良4例，可1例，差1例，优良率达88.2％。术后患者的B？hler角、Gissane角较治疗前显著改善，P＜0.05。结论有限内固定治疗Gustilo Ⅰ～Ⅲ型开放性跟骨骨折方法简便，既能有效地复位固定，而且对开放性创面的处理有明显优势，大大降低皮肤感染或坏死的概率，减少创伤，是治疗开放性跟骨骨折的有效方法。
Objective To evaluate the application of limited internal fixation（ Kirschner,hollow nail） and its effect in the treatment of Gustilo typeⅠ-Ⅲopen fracture.Methods Seventeen cases（15 males and 2 females aged from 23-64 years with an average age of 43.5 years） of Gustilo typeⅠ-Ⅲopen fractures were treated with limit-ed internal fixation.The healing status,B？hler’ s angle before and after the treatment,the angle of Gissane were ob-served.Results All patients were healed, among them 4 cases suffered soft tissue defects and healed after skin flap.All patients were followed up for 6-12 months,average 10 months.All fractures healed without loss of reduc-tion.According to Maryland foot score,11 cases were excellent,4 cases were good and 1 case was poor;the excel-lent and good rate was 88.2%.B？hler’ s angle of patients and the angle of Gissane improved significantly after treatment （P〈0.05）.Conclusion Limited internal fixation has advantages in the treatment of open wound and greatly reduces the probability of infection or necrosis of the skin.It is a simple and effective method in the treat-ment of Gustilo type I-Ⅲopen fracture.
出处
《创伤外科杂志》
2015年第3期232-235,共4页
Journal of Traumatic Surgery
关键词
跟骨骨折
内固定
感染
清创
calcaneal fracture
internal fixation
infection
debridement
