【摘要】：目的探討閉合復位或有限切開復位、螺紋克氏針或螺釘內(nèi)固定結合組合式外固定支架固定治療跟骨關節(jié)內(nèi)骨折臨床療效。方法回顧分析自2012年3月至2015年9月,采用閉合復位或有限切開復位、螺紋克氏針或螺釘內(nèi)固定結合組合式外固定支架固定治療跟骨關節(jié)內(nèi)骨折36例(40足),男24例,女12例;年齡21~55歲,平均39.6歲。比較術前、術后軸側(cè)位Bohler角、Gissane角恢復情況。采用美國足踝外科學會(AOFAS)踝-后足評分評價功能情況。結果 36例(40足)均獲得隨訪,隨訪時間6~30個月,平均24.2個月,術后軸側(cè)位攝片及CT檢查跟骨高度、寬度、跟距關節(jié)及跟骰關節(jié)解剖關系恢復良好,Bohler角恢復到23°~40°,平均(31.2±6.3)°,Gissane角恢復到105°~132°,平均(123.3±8.1)°,術前、后Bohler角、Gissane角比較差異有統(tǒng)計學意義(P0.01)。本組40足末次隨訪時依照AOFAS評分:優(yōu)22足,良13例,可5例,優(yōu)良率87.5%。結論微創(chuàng)復位有限內(nèi)固定結合外支架固定治療跟骨骨折,取材方便、簡單易行,同時對粉碎較重骨折也有較好療效。
[Abstract]:Objective to investigate the clinical effect of closed reduction or limited open reduction, Kirschner's needle or screw internal fixation combined with combined external fixation in the treatment of intra-articular calcaneal fracture. Methods from March 2012 to September 2015, 36 cases (40 feet) of intra-articular calcaneal fractures were treated with closed reduction or limited open reduction, screw internal fixation and combined external fixation, including 24 males and 12 females. The average age was 39.6 years. To compare the recovery of Bohler angle before and after operation. The functional status was evaluated with the (AOFAS) ankle-hind foot score of the American Society of foot and ankle surgery. Results 36 cases (40 feet) were followed up for 6 ~ 30 months (mean 24.2 months). The height and width of calcaneus were examined by axial radiography and CT. The anatomical relationship between calcaneal joint and calcaneocuboid joint was well restored to 23 擄and 40 擄, and the average angle of Gissane was (31.2 鹵6.3) 擄to 105 擄, with an average of (123.3 鹵8. 1) 擄. There was a significant difference in the angle of Bohler before operation (P0. 01). According to AOFAS score, excellent 22 feet, good 13 cases, fair 5 cases, excellent and good rate 87.5%. Conclusion minimally invasive reduction and limited internal fixation combined with external fixation for calcaneal fractures are convenient, simple and effective in the treatment of severe comminuted fractures.
【作者單位】： 貴州省骨科醫(yī)院骨外三科;
【分類號】：R687.3
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本文編號：2143778