本文關(guān)鍵詞： 跟骨骨折 跗骨竇切口 空心釘 微型鎖定鋼板　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的探討經(jīng)跗骨竇切口采用空心釘及微型鎖定鋼板治療跟骨骨折能否達(dá)到穩(wěn)定內(nèi)固定效果及兩種內(nèi)固定方式之間的差別。方法采取回顧性病例對(duì)照研究設(shè)計(jì)方案,從2014年3月至2016年1月于我院創(chuàng)傷骨科接受跟骨骨折手術(shù)治療的患者中篩選符合研究標(biāo)準(zhǔn)的病例,采用跗骨竇切口空心釘和微型鎖定鋼板內(nèi)固定治療跟骨骨折,收集病例58例患者共63足,全部為閉合性骨折,未合并糖尿病,周?chē)苄约膊〖捌渌麌?yán)重基礎(chǔ)疾病。其中采用跗骨竇切口+空心釘內(nèi)固定36足(33人,A組),采用跗骨竇切口+微型鎖定鋼板內(nèi)固定27足(26人,B組)。采集兩組患者基本資料,對(duì)比手術(shù)前與隨訪時(shí)跟骨的高度、寬度、軸長(zhǎng)、B?hler角以及Gissane角的變化情況,術(shù)前等待時(shí)間,手術(shù)時(shí)間,術(shù)后并發(fā)癥的發(fā)生率。采用Maryland評(píng)分(MFS)來(lái)評(píng)價(jià)最終手術(shù)效果。結(jié)果兩組患者術(shù)前一般資料比較(性別,年齡,術(shù)前等待時(shí)間,Sanders分型,致傷原因,術(shù)前跟骨寬度、高度、軸長(zhǎng)、B?hler角、Gissane角)進(jìn)行比較,兩組間差別無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。A組手術(shù)時(shí)間較B組短(P0.05);隨訪時(shí)兩組跟骨寬度、高度、軸長(zhǎng)、B?hler角、Gissane角較術(shù)前都有明顯改善(P0.05),組間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);Sanders II型Maryland足部評(píng)分無(wú)明顯差異(P0.05),SandersⅢ型空心釘組評(píng)分較鋼板組差。結(jié)論采用空心釘或者微型鎖定鋼板兩種手術(shù)方式治療跟骨關(guān)節(jié)內(nèi)骨折隨訪時(shí)跟骨寬度、高度、軸長(zhǎng)、B?hler角和Gissane角都較術(shù)前明顯改善,對(duì)于SandersⅡ型患者,兩組手術(shù)療效無(wú)明顯差異;對(duì)于SandersⅢ型患者,微型鎖定鋼板內(nèi)固定臨床效果優(yōu)于空心釘內(nèi)固定,對(duì)跟骨骨折內(nèi)固定方式的選擇具有一定的指導(dǎo)意義�？招尼攦�(nèi)固定方式手術(shù)時(shí)間較微型鋼板短。
[Abstract]:Objective to investigate the incision of the tarsal sinus between hollow screws and mini locking plate for treatment of calcaneal fractures can achieve stable fixation and the effect of two kinds of internal fixation methods. The difference between the methods of retrospective control study design cases, from March 2014 to January 2016 in the Department of orthopedics of our hospital trauma surgery for the treatment of calcaneal fracture patients were met the study criteria the cases of tarsal sinus and micro incision cannulated screw locking plate fixation of calcaneal fractures, 58 cases of patients with a total of 63 foot, all fractures were closed, without diabetes, peripheral vascular disease and other serious underlying disease. The tarsal sinus incision and cannulated screw fixation (36 foot 33, A the tarsal sinus group), incision Mini locking plate fixation + 27 foot (26, B). The two groups were collected the basic information of height and follow-up calcaneal contrast before surgery, width B, axial length, hler angle and Gissane? Change angle, waiting time, operative time, postoperative complication rate. The Maryland score (MFS) to evaluate the effect of the operation. The final results of two groups of patients before general data (sex, age, waiting time, preoperative Sanders typing the causes of injury, preoperative, calcaneal width, height, length, B? Hler angle, Gissane angle) were compared, the difference between the two groups was not statistically significant (P0.05) the operation time of.A group was shorter than that of group B (P0.05); two groups of calcaneal width, height, length, hler angle B?, Gissane angle before and after operation were obviously improved (P0.05), there was no significant difference between groups (P0.05); no significant difference between the Sanders type II Maryland foot score (P0.05), Sanders type hollow nail group score than plate group. Conclusion using cannulated screws or locking type micro surgical methods of two plate treatment the follow-up of intra-articular calcaneal fractures When the calcaneal width, height, length, B angle and Gissane? Hler are significantly improved compared with preoperative, Sanders for type II patients, no significant difference in efficacy for the operation of two groups; Sanders patients with type III, mini locking plate fixation is better than the clinical effect of cannulated screw fixation, has certain guiding significance to the internal fracture of calcaneus the choice of fixation methods. Hollow screw fixation with mini plate operation time is short.

【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R687.3

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