中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
5期
3-5
,共3页
跟骨%骨折%外科手术%内固定器%Sanders Ⅳ型
跟骨%骨摺%外科手術%內固定器%Sanders Ⅳ型
근골%골절%외과수술%내고정기%Sanders Ⅳ형
Calcaneus%Fractures,bone%Surgical procedures,operative%Internal fixators%Sanders Ⅳ
目的 比较不同术式治疗Sanders Ⅳ型跟骨骨折的疗效,以探讨跟骨骨折的最佳术式.方法 选取进行手术治疗的64例(70足)Sanders Ⅳ型跟骨骨折患者,其中内固定加距下关节融合组33例35足,AO钢板内固定组31例35足.比较两组患者手术时间、术中出血量以及手术前后Bohler角、Gissane角,并采用Maryland足部评分系统对踝关节功能做出评价.结果 内固定加距下关节融合组手术时间(89.1±6.4)min,术中出血量(138.9±20.3)ml,均多于AO钢板内固定组的(75.4±5.7)min、(118.4±14.2)ml,两组比较差异有统计学意义(P＜0.05).两组术前、术后Bohler角、Gissane角比较差异无统计学意义(P＞0.05),但术后较术前均明显改善(P＜0.01).术后1年内固定加距下关节融合组踝关节功能优良率为82.86%(29/35),显著高于AO钢板内固定组的68.57%(24/35),两组比较差异有统计学意义(P＜0.05).结论 内固定加距下关节融合治疗Sanders Ⅳ型跟骨骨折的疗效可能优于单纯AO钢板内固定,故可优先考虑内固定加距下关节融合治疗Sanders Ⅳ型跟骨骨折.
目的 比較不同術式治療Sanders Ⅳ型跟骨骨摺的療效,以探討跟骨骨摺的最佳術式.方法 選取進行手術治療的64例(70足)Sanders Ⅳ型跟骨骨摺患者,其中內固定加距下關節融閤組33例35足,AO鋼闆內固定組31例35足.比較兩組患者手術時間、術中齣血量以及手術前後Bohler角、Gissane角,併採用Maryland足部評分繫統對踝關節功能做齣評價.結果 內固定加距下關節融閤組手術時間(89.1±6.4)min,術中齣血量(138.9±20.3)ml,均多于AO鋼闆內固定組的(75.4±5.7)min、(118.4±14.2)ml,兩組比較差異有統計學意義(P＜0.05).兩組術前、術後Bohler角、Gissane角比較差異無統計學意義(P＞0.05),但術後較術前均明顯改善(P＜0.01).術後1年內固定加距下關節融閤組踝關節功能優良率為82.86%(29/35),顯著高于AO鋼闆內固定組的68.57%(24/35),兩組比較差異有統計學意義(P＜0.05).結論 內固定加距下關節融閤治療Sanders Ⅳ型跟骨骨摺的療效可能優于單純AO鋼闆內固定,故可優先攷慮內固定加距下關節融閤治療Sanders Ⅳ型跟骨骨摺.
목적 비교불동술식치료Sanders Ⅳ형근골골절적료효,이탐토근골골절적최가술식.방법 선취진행수술치료적64례(70족)Sanders Ⅳ형근골골절환자,기중내고정가거하관절융합조33례35족,AO강판내고정조31례35족.비교량조환자수술시간、술중출혈량이급수술전후Bohler각、Gissane각,병채용Maryland족부평분계통대과관절공능주출평개.결과 내고정가거하관절융합조수술시간(89.1±6.4)min,술중출혈량(138.9±20.3)ml,균다우AO강판내고정조적(75.4±5.7)min、(118.4±14.2)ml,량조비교차이유통계학의의(P＜0.05).량조술전、술후Bohler각、Gissane각비교차이무통계학의의(P＞0.05),단술후교술전균명현개선(P＜0.01).술후1년내고정가거하관절융합조과관절공능우량솔위82.86%(29/35),현저고우AO강판내고정조적68.57%(24/35),량조비교차이유통계학의의(P＜0.05).결론 내고정가거하관절융합치료Sanders Ⅳ형근골골절적료효가능우우단순AO강판내고정,고가우선고필내고정가거하관절융합치료Sanders Ⅳ형근골골절.
Objective To compare the different methods in the treatment of calcaneal fractures.Methods Sixty-four patients (70 feet) with calcaneal fractures were involved in this study,35 feet were treated by subtalar joint arthrodesis (group A) and 35 feet were treated by AO plate with extended lateral approach (group B).The operation time,amount of bleeding,Bohler angle and Gissane angle before and after operation were measured and compared,and Maryland score was also analyzed respectively after operation.Results The operation time [ (89.1 ± 6.4) min ] and amount of bleeding [ ( 138.9 ± 20.3) ml ] in group A were significantly more than those in group B [ (75.4 ± 5.7) min,( 118.4 ± 14.2 ) ml ] (P ＜ 0.05 ).There was no significant difference in Bohler angle and Gissane angle before and after operation between two groups (P ＞ 0.05 ),but they were improved after operation compared with those before operation in two groups (P ＜0.01 ).There was significant difference of the Maryland score in postoperative 1 year between group A ( 82.86%,29/35 ) and group B ( 68.57%,24/35 ) (P ＜ 0.05 ).Conclusion The effectiveness of subtalar joint arthrodesis may outstrip AO plate with extended lateral approach.
