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经皮撬拨复位空心钉内固定治疗Sanders Ⅱ、Ⅲ型跟骨骨折 被引量:31

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摘要 [目的]评估经皮撬拨复位空心钉内固定治疗SandersⅡ型及Ⅲ型跟骨骨折的疗效。[方法]回顾分析2011年12月-2015年2月收治并获得随访的移位的跟骨关节内骨折患者23例(23足),其中男20例(20足),女3例(3足);年龄18-70岁,平均38.4岁。左侧14足,右侧9足;开放性骨折2例(2足),闭合性骨折21例(21足)。根据跟骨骨折Sanders分型:Ⅱ型13例,Ⅲ型10例。手术均采用经皮斯氏针撬拨复位空心螺钉内固定治疗。术后定期拍摄X线片明确骨折愈合情况,测量Bhler角和Gissane角。采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足评分标准评价患足功能。[结果]23例患者均获得随访,时间12-47个月,平均22.8个月。术后无针道感染和骨髓炎发生。所有患者均获得骨性愈合,愈合时间8-14周,平均10.4周。末次随访时患者Bhler角和Gissane角分别为(29.35±1.67)°和(121.83±4.45)°,与术前的(15.17±4.39)°和(100.57±6.95)°比较,差异均有统计学意义(t=18.810,P〈0.001;t=12.396,P〈0.001)。末次随访时AOFAS踝与后足评分为58-100分,平均86.4分,其中优12例、良8例、可2例、差1例,优良率86.96%(20/23)。1例SandersⅢ型骨折术后6周复位丢失,6个月后并发距下关节创伤性关节炎。[结论]SandersⅡ型跟骨骨折最适宜闭合撬拨复位空心螺钉固定,SandersⅢ型骨折若移位的骨折块比较大,且术者能充分领悟骨折的移位机制和三维空间位置,通过撬拨也能够较好的实现复位,方法微创,固定可靠,并发症少。
出处 《中国矫形外科杂志》 CAS CSCD 北大核心 2016年第16期1508-1513,共6页 Orthopedic Journal of China
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参考文献23

  • 1Tomesen T,Biert J,Frolke JP.Treatment of displaced intra-articular calcaneal fractures with closed reduction and percutaneous screw fixation[J].J Bone Joint Surg Am,2011,93(10):920-928.
  • 2Rammelt S,Zwipp H.Calcaneus fractures:facts,controversies and recent developments[J].Injury,2004,35(5):443-461.
  • 3Sanders R,Fortin P,Di Pasquale T,et al.Operative treatment in 120displaced intraarticular calcaneal fractures.Results using a prognostic computed tomography scan classification[J].Clin Orthop,1993,290(290):87-95.
  • 4Di SM,Bensaida M,Vandenbussche E,et al.Results of open reduction and cortico-cancellous autograft of intra-articular calcaneal fractures according to Palmer[J].Rev Chir Orthop Reparatrice Appar Mot,2008,94(2):135-144.
  • 5Gougoulias N,Khanna A,Mc Bride DJ,et al.Management of calcaneal fractures:systematic review of randomized trials[J].Br Med Bull,2009,92(1):153-167.
  • 6Harvey EJ,Grujic L,Early JS,et al.Morbidity associated with ORIF of intra-articular calcaneus fractures using a lateral approach[J].Foot Ankle Int,2001,22(11):868-873.
  • 7Rammelt S,Amlang M,Barthel S,et al.Percutaneous treatment of less severe intraarticular calcaneal fractures[J].Clin Orthop,2010,468(4):983-990.
  • 8Rammelt S,Barthel S,Biewener A,et al.Calcaneus fractures.Open reduction and internal fixation[J].Zentralbl Chir,2003,128(6):517-528.
  • 9Folk JW,Starr AJ,Early JS.Early wound complications of operative treatment of calcaneus fractures:analysis of 190 fractures[J].J Orthop Trauma,1999,13(5):369-372.
  • 10Hammond AW,Crist BD.Percutaneous treatment of high-risk patients with intra-articular calcaneus fractures:a case series[J].Injury,2013,44(11):1483-1485.

二级参考文献58

  • 1俞光荣,梅炯,朱辉,杨云峰,李海丰,陈雁西,燕晓宇,袁峰,周家钤,程黎明.保留距下关节的跟骨截骨矫形术治疗跟骨骨折畸形愈合[J].中华骨科杂志,2005,25(1):35-40. 被引量:28
  • 2俞光荣,朱辉,燕晓宇,张凯,周家钤,袁锋,梅炯,李海丰,程黎明,陈雁西,杨云峰.小蝶形钛钢板的研制及其在跟骨关节内骨折手术中的应用[J].中华创伤杂志,2005,21(10):750-754. 被引量:25
  • 3Gallie WE.Subastragalar arthrodesis in fractures of the os calcis.J Bone Joint Surg(Am),1943,25:731-736.
  • 4Benirschke SK,Sangeorzan BJ.Extensive intraarticular fractures of the foot:surgical management of calcaneal fractures.Clin Orthop Relat Res,1993,(292):128-134.
  • 5Burdeaux BD Jr.Reduction of calcaneal fractures by the McReynolds medial approach technique and its experimental basis.Clin Orthop Relat Res,1983,(177):87-103.
  • 6Zwipp H,Tscherne H,Wulker N,et al.Intra-articular fracture of the calcaneus:classification,assessment and surgical procedures.Unfallchirurg,1989,92:117-129.
  • 7Zwipp H,Rammelt S,Gavlik JM,eds.Calcaneus fractures.In:Duparc J,ed.Surgical techniques in orthopedics and traumatology.Paris:Elsevier,2001.1-7.
  • 8Stephenson JR.Surgical treatment of displaced intraarticular fractures of the calcaneus:a combined lateral and medial approach.Clin Orthop Relat Res,1993,(290):68-75.
  • 9Canale ST.Campbell's operative orthopaedics.9th ed.St.Louis:CV Mosby Co,1998.1930.
  • 10Geel CW,Flemister AS Jr.Standardized treatment of intra-articular calcaneal fractures using an oblique lateral incision and no bone graft.J Trauma,2001,50:1083-1089.

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