摘要
目的探讨关节镜辅助下经跗骨窦入路钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折的临床疗效。方法2015年6月至2018年6月,在关节镜辅助下经跗骨窦入路钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折患者24例。其中,男18例,女6例;年龄21~59岁,平均35.9岁;左侧9例,右侧15例;损伤原因:高处坠落伤21例,车祸伤3例。SandersⅡ型16例(ⅡA型2例,ⅡB型8例,ⅡC型6例),Ⅲ型8例(ⅢAB型3例,ⅢAC型2例,ⅢBC型3例)。术前及术后均行X线及CT检查,评估骨折分型、骨折复位及愈合情况,记录患者术前及术后的Bohler角、Gissane角以及AOFAS后足功能评分。结果24例患者均获得随访,随访时间为6~36个月,平均随访时间20个月。患者术后跟距关节面平整度较术前明显改善,Bohler角由术前18.8°±0.6°改善为末次随访时的29.5°±2.7°,两者比较差异有统计学意义(t=1.321,P=0.001)。Gissane角由术前100.4°±4.6°改善为末次随访时的121.3°±5.4°,两者比较差异有统计学意义(t=2.198,P=0.001),末次随访时AOFAS评分:优12例,良9例,可3例。结论关节镜辅助下经跗骨窦入路钢板内固定适用于SandersⅡ、Ⅲ型跟骨骨折的治疗,可获得良好的复位和固定,是一种有效、可行的治疗方法。
Objective To investigate the clinical effect of arthroscopic-assisted tarsal sinus approach plate internal fixation in the treatment of Sanders typeⅡandⅢcalcaneal fractures.Methods From June 2015 to June 2018,24 patients(18 males and 6 females)with Sanders typeⅡandⅢcalcaneal fractures were treated with plate internal fixation through tarsal sinus approach assisted by arthroscopy.Their age ranged from 21 to 59 years,with an average age of 35.9 years.There were 9 cases on the left side and 15 cases on the right side.The causes of injury were 21 cases of falling injury and 3 cases of traffic accident injury.There were 16 cases of Sanders typeⅡtype(2 cases of typeⅡA,8 cases of typeⅡB and 6 cases of typeⅡC)and 8 cases of typeⅢ(3 cases of typeⅢAB,2 cases of typeⅢAC and 3 cases of typeⅢBC).X-ray and CT examination were performed before and after operation to evaluate the classification of fracture,reduction and healing of fracture.Bohler angle,Gissane angle and AOFAS posterior foot function score were recorded before and after operation.Results All the 24 patients were followed up.The follow-up period was 6 to 36 months,with an average of 20 months.The calcaneal articular surface flatness was significantly improved after operation.The Bohler angle was improved from 18.8°±0.6°(before operation)to 29.5°±2.7°(at the last follow-up),and there was significant difference before and after operation(t=1.321,P=0.001).The Gissane angle was improved from 100.4°±4.6°(before operation)to 121.3°±5.4°(at the last follow-up).There was significant difference before and after operation(t=2.198,P=0.001).At the last follow-up,the AOFAS score was excellent in 12 cases,good in 9 cases and fair in 3 cases.Conclusion Arthroscopy-assisted internal fixation with tarsal sinus plate is effective in the treatment of Sanders typeⅡandⅢcalcaneal fractures.It was a feasible treatment.
作者
吴佳俊
沈超
付备刚
周小小
高峰
王明辉
Wu Jiajun;Shen Chao;FuBeigang;ZhouXiaoxiao;Gao Feng;Wang Minghui(Department of Orthopedics,Zhoupu Hospital Affiliated to Shanghai University of Medicine&Health Sciences,Shanghai,201318,China)
出处
《生物骨科材料与临床研究》
CAS
2019年第5期31-34,共4页
Orthopaedic Biomechanics Materials and Clinical Study
基金
上海市浦东新区临床特色学科基金资助（PWYts2018-2）
上海市浦东新区卫生和计划生育委员会特色专病专项基金资助（PWZzb2017-33）
上海市浦东新区卫生和计划生育委员会科技发展专项基金资助（PW2016A-21)上海市浦东新区卫生系统重点学科群建设资助（PWZxq2017-12）
关键词
跟骨骨折
关节镜
跗骨窦入路
Calcaneal fracture
Arthroscopy
Tarsal sinus approach
