摘要
[目的]介绍分期手术治疗GustiloⅢB型跟骨骨折的手术技术和初步临床结果。[方法]2013年01月~2019年08月对9例GustiloⅢB型跟骨骨折患者采用分期手术治疗,一期伤口彻底清创,跟骨骨折功能复位,采用克氏针及拉力螺钉内固定,二期创面反复多次清创,确定无感染后行皮瓣覆盖。[结果]9例患者手术顺利,均未截肢,患者平均住院时间(39.06±4.31)d。2例患者皮瓣边缘愈合不良,经伤口换药后分别于3个月及5个月伤口愈合。2例患者距下关节面解剖复位,7例患者功能复位。所有患者跟骨B?hler角、Gissane角、跟骨高度、宽度恢复满意,与术前比较差异均有统计学意义(P<0.05)。末次随访Mazur踝关节症状与功能评分评估疗效:优1例,良7例,可1例。[结论]分期手术治疗GustiloⅢB型开放性跟骨骨折技术可行,临床疗效良好。
[Objective]To introduce the surgical technique and preliminary clinical results of staged surgical treatment for Gustilo typeⅢB calcaneal fracture.[Methods]From January 2013 to August 2019,9 patients were treated by staged surgeries for Gustilo typeⅢB calcaneal fractures.In the first-stage,the wound was thoroughly debrided,the calcaneal fracture was functionally reduced,and fixed with Kirschner wires or lag screws.Subsequently,the wound was debrided several times until no infection was confirmed,and then the skin flap was transferred to cover the residual wound.[Results]All the 9 patients had the surgical procedures finished smoothly without amputation in anyone of them,with average hospital stay of(39.06±4.31)days.Of them,2 patients got poor healing of the edges of the flaps,which healed at 3 and 5 months respectively after dressing changes.In term of radiographic assessment,anatomical reduction of the subtalar articular surface was achieved in 2 patients and functional reduction recovered in 7 patients.The B?hler angle,Gissane angle,height and width of the calcaneus in all patients recovered satisfactorily,and the difference between those before operation and at the latest follow-up was statistically significant(P<0.05).Based on Mazur ankle symptom and function criteria,the clinical outcomes were marked as excellent in 1 case,good in 7 cases,and fair in 1 case at the last follow-up.[Conclusion]The staged surgical treatment is feasible,and achieve satisfactory clinical outcomes for Gustilo typeⅢB calcaneal fracture.
作者
石永新
李富琴
宋晖
廖怡清
SHI Yong-xin;LI Fu-qin;SONG Hui;LIAO Yi-qing(Department of Traumatic Orthopaedics,Shenzhen Hospital,University of Chinese Academy of Sciences(Guangming),Shenzhen 518106,China;Honghuashan Social Health Center,Shenzhen Hospital,University of Chinese Academy of Sciences(Guangming),Shenzhen 518106,China;Department of Hand Surgery and Microsurgery,Shenzhen Hospital,University of Chinese Academy of Sciences(Guangming),Shenzhen 518106,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2021年第8期738-741,共4页
Orthopedic Journal of China
关键词
跟骨骨折
开放性骨折
内固定
分期手术
calcaneal fractures
open fractures
internal fixation
staged surgery
