中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2008年
5期
421-424
,共4页
李喜功%孙俊英%殷浩%宋兵华%朱若夫%唐祖林
李喜功%孫俊英%慇浩%宋兵華%硃若伕%唐祖林
리희공%손준영%은호%송병화%주약부%당조림
跟骨骨折%骨折固定术,内%治疗结果
跟骨骨摺%骨摺固定術,內%治療結果
근골골절%골절고정술,내%치료결과
Calcaneal fractures%Fracture fixation,internal:Treatment outcome
目的 评定切开复位内固定治疗移位的跟骨关节内骨折的疗效,并分析其影响因素.方法 回顾性分析2004年3月至2006年7月收治的采用切开复位内固定治疗的移位跟骨关节内骨折40例(46足).按照Sanders分型:Ⅱ型16足,Ⅲ型19足,Ⅳ型11足,总结评定其临床疗效并分析影响疗效的相关因素. 结果 所有患者均得到随访,平均随访18个月(13～28个月).根据Maryland足部评分系统评价术后疗效:优21足,良16足,可6足,差3足,优良率82.6%.优良率在不同骨折类型中分别为:Ⅱ型93.8%(15/16),Ⅲ型84.2%(16/19),1V型54.5%(6/11);伤后至手术时间≤14 d组和＞14d组分别为87.2%(34/38)和42.9%(3/8);在术后B0hler角＜15°组和≥15°组分别为37.5%(2/9)和89.5%(35/37);关节面复位质量≤2 mm组和＞2 mm组分别为91.2%(32/33)和45.5%(5/13).对各因素的优良率比较,差异有统计学意义(P＜0.05). 结论 切开复位内固定治疗移位的跟骨关节内骨折,治疗效果好.骨折类型、伤后至手术时间、术后Bohler角的恢复程度、关节内骨折的复位质量为影响其术后疗效的重要因素.
目的 評定切開複位內固定治療移位的跟骨關節內骨摺的療效,併分析其影響因素.方法 迴顧性分析2004年3月至2006年7月收治的採用切開複位內固定治療的移位跟骨關節內骨摺40例(46足).按照Sanders分型:Ⅱ型16足,Ⅲ型19足,Ⅳ型11足,總結評定其臨床療效併分析影響療效的相關因素. 結果 所有患者均得到隨訪,平均隨訪18箇月(13～28箇月).根據Maryland足部評分繫統評價術後療效:優21足,良16足,可6足,差3足,優良率82.6%.優良率在不同骨摺類型中分彆為:Ⅱ型93.8%(15/16),Ⅲ型84.2%(16/19),1V型54.5%(6/11);傷後至手術時間≤14 d組和＞14d組分彆為87.2%(34/38)和42.9%(3/8);在術後B0hler角＜15°組和≥15°組分彆為37.5%(2/9)和89.5%(35/37);關節麵複位質量≤2 mm組和＞2 mm組分彆為91.2%(32/33)和45.5%(5/13).對各因素的優良率比較,差異有統計學意義(P＜0.05). 結論 切開複位內固定治療移位的跟骨關節內骨摺,治療效果好.骨摺類型、傷後至手術時間、術後Bohler角的恢複程度、關節內骨摺的複位質量為影響其術後療效的重要因素.
목적 평정절개복위내고정치료이위적근골관절내골절적료효,병분석기영향인소.방법 회고성분석2004년3월지2006년7월수치적채용절개복위내고정치료적이위근골관절내골절40례(46족).안조Sanders분형:Ⅱ형16족,Ⅲ형19족,Ⅳ형11족,총결평정기림상료효병분석영향료효적상관인소. 결과 소유환자균득도수방,평균수방18개월(13～28개월).근거Maryland족부평분계통평개술후료효:우21족,량16족,가6족,차3족,우량솔82.6%.우량솔재불동골절류형중분별위:Ⅱ형93.8%(15/16),Ⅲ형84.2%(16/19),1V형54.5%(6/11);상후지수술시간≤14 d조화＞14d조분별위87.2%(34/38)화42.9%(3/8);재술후B0hler각＜15°조화≥15°조분별위37.5%(2/9)화89.5%(35/37);관절면복위질량≤2 mm조화＞2 mm조분별위91.2%(32/33)화45.5%(5/13).대각인소적우량솔비교,차이유통계학의의(P＜0.05). 결론 절개복위내고정치료이위적근골관절내골절,치료효과호.골절류형、상후지수술시간、술후Bohler각적회복정도、관절내골절적복위질량위영향기술후료효적중요인소.
Objective To evaluate open reduction and internal fixation for displaced intra-articular calcaneal fractures and analyze factors affecting its clinical results. Methods From March 2004 to July 2006,46 displaced intra-arficular calcaneal fractures in 40 patients were surgically treated by open reduction and internal fixation.According to Sanders classification,there were 16 cases of type Ⅱ,19 cases of type Ⅲ and 11 cases of type Ⅳ. Results All the patients were followed up for anaverage of 18(13 to 28)months.The effects of treatment were evaluated according to Maryland Foot Score:excellent in 21 feet,good in 16 feet,fair in 6 feet,poor in 3 feet. The total good to excellent ratewas 82.6%.The respective good to excellent rates were 93.8%for type Ⅱ fractures,84.2%for type Ⅲ,and 54.5%for type Ⅳ;87.2%for the group with time interval from injury to surgery ≤14d,and 42.9%for the group with time interval＞14d;37.5%for thegroup with B(o)hler angle＜15°,and 89.5% for the group with B(o)hler angle≥15 °.91.2%for the group with reduction of intra-articular calcaneal fractures ≤2 mm,and 45.5% for the group with the reduction＞2mm.The differences within each factor group were statistically significant(P＜0.05). Conclusions Open reduction and internal fixation fordisplaced intra-articularcalcaneal fractures is a good method.Fracture type,time interval from injury to surgery,B(o)hler angle reduction,reduction of intra-articular calcaneal fractures are important factors affecting outcome of operation.
