摘要
目的 ：探讨载距突螺钉导向器辅助固定治疗跟骨骨折的临床疗效。方法 ：2012年5月至2013年10月收集50例（60足）跟骨骨折患者,将其分为跟骨载距突螺钉导向器辅助治疗组（A组）,普通螺钉导向器组（B组）。A组男22例,女3例;年龄17~75岁,平均（45.08±11.98）岁;根据Sanders分型：Ⅱ型9足,Ⅲ型16足,Ⅳ型7足。B组男20例,女5例;年龄19~78岁,平均（46.36±15.74）岁;根据Sanders分型：Ⅱ型8足,Ⅲ型13足,Ⅳ型7足。观察并比较两组患者手术前后影像学指标的变化、手术时间、术后并发症情况,术后1年采用Maryland足评分进行疗效评价。结果：50例患者获得随访,A组随访时间12~24个月,平均（17.72±4.08）个月;B随访时间12~24个月,平均（18.68±3.40）个月,两组随访时间比较差异无统计学意义（（P〉0.05）。两组患者手术时间、并发症、透视次数比较差异有统计学意义（P〈0.05）。两组患者各自手术前后B觟hler角和Gissanes角比较差异有统计学意义（P〈0.05）。A组术后1年Maryland足部评分总分为（84.94±12.75）,B组为（76.96±15.32）,两组比较差异有统计学意义（P〈0.05）。结论 ：采用该载距突螺钉导向器辅助固定跟骨的关节内骨折,手术时间短,透视次数少,并发症少及术后功能恢复较好,能为跟骨关节内骨折提供一种新的辅助方法。
Objective：To explore clinical outcomes of director for sustentaculum tali screwing for fixing sustentaculum tali of calcaneus. Methods：From May 2012 to October 2013,totally 50 patients（ 60 feet） with calcaneal fractures were analyzed,and divided into director for sustentaculum calcaneous tali screwing treatment group（group A） and ordinary screwing group（group B）. In group A,there were 25 patients,including 22 males and 3 females,aged from 17 to 75 years old with an average of（45.08±11.98） years; according to Sanders classification,9 feet were typeⅡ,16 feet were type Ⅲ,and 7 feet were type Ⅳ.In group B,there were 25 patients,including 20 males and 5 females,aged from 19 to 78 years old with an average of（46.36±15.74） years; according to Sanders classification,8 feet were typeⅡ,13 feet were type Ⅲ,and 7 feet were type Ⅳ. Radiological change,operative time,postoperative complications were observed and compared,Maryland scoring at 1 year after operation was applied to evaluate clinical outcomes. Results：Fifty patients were followed up,group A was followed up from 12 to 24 months with an average of（17.72 ±4.08） months;while group B was followed up from 12 to 24 months with an average of（18.68±3.40） months;there was no significant difference between two groups in following up time（P0.05）. There were significant difference in operative time,complications and fluoroscopy times between two groups（P 〉0.05）. There were significant difference in Bhler angle and Gissanes angle between two groups before and after operation（P 〈0.05）. Maryland score at 1year after operation in group A was（84.94 ±12.75） and（76.96 ±15.32） in group B,had significant meaning between two groups（P〈0.05）. Conclusion：Fixation of sustentaculum tali of calcaneus aided by director for sustentaculum tali screwing,has advantages of less operative time,fluoroscopy times,incidence of complications and good recovery of function,which could provide a new aiding method for treating intra articular calcaneal fractures.
出处
《中国骨伤》
CAS
2016年第12期1097-1103,共7页
China Journal of Orthopaedics and Traumatology
基金
宁波市临床特色重点专科项目基金号(编号:2013-88)~~
关键词
跟骨
骨折
骨折固定术
骨牵引复位法
Calcaneus
Fractures
Fracture fixation
Skeletal tracting reposition
