摘要
目的 设计一种带有距下关节加压融合功能的新型跟骨接骨板,评价其应用于SandersⅣ型跟骨骨折的临床疗效。方法 使用自行设计的距下关节融合板对50例需要一期融合距下关节的SandersⅣ型跟骨骨折患者进行内固定治疗,观察患者术前、术后和末次随访时的Bolher角、Gissane角以评估跟骨解剖形态,并采用美国足踝外科协会(AOFAS)踝-后足评分评估术后功能。结果 50例患者均顺利完成手术,手术时间37~72 min,平均(48.04±9.32) min,术中出血量90~140 mL,平均(106.00±12.04) mL,术中均无重要神经、血管损伤;50例患者均获得随访,随访时间12~21个月,平均(16.36±2.24)个月;50例患者末次随访时均达到骨性愈合,骨性愈合时间为8~14周,平均(9.52±1.25)周。术后、末次随访时,患者Bolher角、Gissane角均大于术前,差异有统计学意义(P<0.001);患者术后Bolher角、Gissane角与末次随访时比较,差异无统计学意义(P=0.372、0.140)。末次随访时,患者平均AOFAS踝-后足评分为(83.78±5.61)分,优9足(90~100分)、良39足(75~<90分)、可2足(50~<75分),优良率为96.00%;3例患者术后出现切口皮缘坏死,经过多次换药后切口愈合。结论 距下关节融合板设计合理,可以提供坚强、牢固的固定,术中骨折复位满意,手术操作简单,是治疗需要一期融合距下关节的SandersⅣ型跟骨骨折的理想内固定材料。
Objective To design a new calcaneal plate with function of subtalar joint compression fusion,and to evaluate its clinical effect for Sanders typeⅣcalcaneal fracture.Methods A total of 50 cases with Sanders typeⅣcalcaneal fracture requiring primary subtalar joint fusion were treated with internal fixation using a self-designed subtalar joint fusion plate.The anatomical morphology of the calcaneus was evaluated by observing Bolher Angle and Gissane Angle before operation,after operation and at the last follow-up,and the postoperative function was evaluated by the American Association of Foot and Ankle Surgery(AOFAS)ankle-posterior foot score.Results All 50 patients completed operations successfully,the operation time was from 37 to 72 min,with an average of(48.04±9.32)min,intraoperative bleeding volume was from 90 to 140 mL,with an average of(106.00±12.04)mL.There was no significant nerve and vascular injury during operation.All 50 patients were followed up,with follow-up time of 12 to 21 months and an average of(16.36±2.24)months.Bone healing was achieved at the last follow-up in all 50 patients,and the healing time was 8 to 14 weeks,with an average of(9.52±1.25)weeks.The postoperative and final follow-up Bolher angles were significantly larger compared with that before surgery(P<0.001),while there were no statistically significant differences in Bolher angle and Gissane angle between postoperative and final follow-up(P=0.372,0.140).AOFAS score at the last follow-up was(83.78±5.61),including 9 feet with excellent rating(score of 90 to 100),39 feet with fine rating(score of 75 to less than 90),and 2 feet with good rating(score of 50 to less than 75),with an excellent and good rate of 96.00%.Postoperative skin edge necrosis occurred in 3 patients,and wound healed after multiple dressing changes.Conclusion The subtalar joint fusion plate is reasonable in designand can provide strong and firm fixation,with satisfactory intraoperative fracture reductionand simple operation.It is an ideal internal fixation material for Sanders typeⅣcalcaneal fracture requiring primary subtalar joint fusion.
作者
王亚鹏
付炳金
孙广超
尹刚
杜瑞
邓明明
朱晓东
WANG Yapeng;FU Bingjin;SUN Guangchao;YIN Gang;DU Rui;DENG Mingming;ZHU Xiaodong(Department of Foot and Ankle Surgery,Affiliated Hospital of Binzhou Medical University,Binzhou,Shandong,256603)
出处
《实用临床医药杂志》
CAS
2022年第11期28-33,共6页
Journal of Clinical Medicine in Practice
基金
滨州医学院附属医院科研计划项目(BY2021KJ12)。
关键词
跟骨骨折
距下关节
关节融合
新型
跟骨锁定板
calcaneal fracture
subtalar joint
joint fusion
innovative type
calcaneal locking plate
