本文關鍵詞： 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》2017年碩士論文　論文類型：學位論文

【摘要】：目的探討經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到穩(wěn)定內固定效果及兩種內固定方式之間的差別。方法采取回顧性病例對照研究設計方案,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治療的患者中篩選符合研究標準的病例,采用跗骨竇切口空心釘和微型鎖定鋼板內固定治療跟骨骨折,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,周圍血管性疾病及其他嚴重基礎疾病。其中采用跗骨竇切口+空心釘內固定36足(33人,A組),采用跗骨竇切口+微型鎖定鋼板內固定27足(26人,B組)。采集兩組患者基本資料,對比手術前與隨訪時跟骨的高度、寬度、軸長、B?hler角以及Gissane角的變化情況,術前等待時間,手術時間,術后并發(fā)癥的發(fā)生率。采用Maryland評分(MFS)來評價最終手術效果。結果兩組患者術前一般資料比較(性別,年齡,術前等待時間,Sanders分型,致傷原因,術前跟骨寬度、高度、軸長、B?hler角、Gissane角)進行比較,兩組間差別無統(tǒng)計學意義(P0.05)。A組手術時間較B組短(P0.05);隨訪時兩組跟骨寬度、高度、軸長、B?hler角、Gissane角較術前都有明顯改善(P0.05),組間比較差異無統(tǒng)計學意義(P0.05);Sanders II型Maryland足部評分無明顯差異(P0.05),SandersⅢ型空心釘組評分較鋼板組差。結論采用空心釘或者微型鎖定鋼板兩種手術方式治療跟骨關節(jié)內骨折隨訪時跟骨寬度、高度、軸長、B?hler角和Gissane角都較術前明顯改善,對于SandersⅡ型患者,兩組手術療效無明顯差異;對于SandersⅢ型患者,微型鎖定鋼板內固定臨床效果優(yōu)于空心釘內固定,對跟骨骨折內固定方式的選擇具有一定的指導意義�？招尼攦裙潭ǚ绞绞中g時間較微型鋼板短。
[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.

【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.3

【參考文獻】

相關期刊論文 前8條

1 徐浩;蔣元斌;劉耀輝;黃興銳;;傳統(tǒng)外側“L”形切口鋼板內固定與跗骨竇小切口空心釘內固定治療跟骨骨折的效果比較[J];山東醫(yī)藥;2015年01期

2 李建磊;錢宇;梁文清;韓維奇;酈仕杰;;閉合復位空心釘和解剖型跟骨鈦板內固定治療SandersⅡ、Ⅲ型跟骨骨折療效比較[J];中國骨與關節(jié)損傷雜志;2014年12期

3 徐建民;于超;;改良外側“L”型切口與傳統(tǒng)“L”型切口治療跟骨骨折的比較研究[J];中國矯形外科雜志;2013年22期

4 王冰;李濤;朱裕成;王德廣;馬軍;邱勇;楊春;高殿帥;;跟骨前部與載距突關系的解剖學研究及其臨床意義[J];中國臨床解剖學雜志;2012年02期

5 孔建中;鄭立程;水小龍;郭曉山;李士;;經跗骨竇間隙入路微創(chuàng)內固定治療跟骨關節(jié)內骨折的解剖研究與臨床應用[J];中華創(chuàng)傷雜志;2009年09期

6 鄒宏;王輝;王家洪;彭遠立;;跟骨關節(jié)內骨折的損傷機制和手術治療[J];實用骨科雜志;2008年11期

7 羅斌;朱仰義;馮祖善;;小切口空心釘內固定治療跟骨骨折[J];中國骨與關節(jié)損傷雜志;2008年06期

8 梅炯,俞光榮,朱輝,祝曉忠,李廣君,黎之挺;跟骨載距突的解剖特點及其臨床意義[J];中國臨床解剖學雜志;2002年01期

，

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