CAJ | 학술논문

目的：探讨撬拨复位中空钉内固定与切开复位钛板内固定治疗SandersⅡ、Ⅲ型跟骨骨折早期疗效比较。方法总结我科2010年2月～2013年9月跟骨骨折SandersⅡ、Ⅲ型60例，其中Ⅱ型34例，Ⅲ型26例；随机分成两组，分别采用经皮撬拨复位中空钉内固定、切开复位钛板内固定手术治疗,并进行随访观察，采用Marryland 评分系统进行功能评定。统计两种方法的优良率，进行统计学处理，分析两组差异性。结果60例均获得随访，随访时间4～38个月(平均18个月)，临床疗效：31例行撬拨复位中空钉内固定者，患足功能优20例，良6例，中2例，差3例，功能优良率83.8％；29例行切开复位钛板内固定者，患足功能优18例，良6例，中3例，差2例，功能优良率82.8％，2种方法优良率比较差异无统计学意义（x2=0.617， P=0.971＞0.05）。结论经皮撬拨复位中空钉内固定与切开复位钛板内固定治疗跟骨骨折均能取得良好的效果；经皮撬拨复位中空钉内固定具有创伤微小，操作简便，固定可靠等优点，可以有效防止严重并发症，是一种临床比较实用有效的治疗方法。
목적：탐토효발복위중공정내고정여절개복위태판내고정치료SandersⅡ、Ⅲ형근골골절조기료효비교。방법총결아과2010년2월～2013년9월근골골절SandersⅡ、Ⅲ형60례，기중Ⅱ형34례，Ⅲ형26례；수궤분성량조，분별채용경피효발복위중공정내고정、절개복위태판내고정수술치료,병진행수방관찰，채용Marryland 평분계통진행공능평정。통계량충방법적우량솔，진행통계학처리，분석량조차이성。결과60례균획득수방，수방시간4～38개월(평균18개월)，림상료효：31례행효발복위중공정내고정자，환족공능우20례，량6례，중2례，차3례，공능우량솔83.8％；29례행절개복위태판내고정자，환족공능우18례，량6례，중3례，차2례，공능우량솔82.8％，2충방법우량솔비교차이무통계학의의（x2=0.617， P=0.971＞0.05）。결론경피효발복위중공정내고정여절개복위태판내고정치료근골골절균능취득량호적효과；경피효발복위중공정내고정구유창상미소，조작간편，고정가고등우점，가이유효방지엄중병발증，시일충림상비교실용유효적치료방법。
ObjectiveTo explore and compare the curative effects of percutaneous fracture reduction followed by internal fixation with cannulated screws and open reduction followed by internal fixation with titanium plate in the treatment of Sanders typeⅡ andⅢ calcaneal fracture at early stage.Methods 60 patients with calcaneal fracture from February 2010 to September 2013 were selected. They all belonged to Sanders typeⅡ andⅢ fracture, in which 34 patients were typeⅡ and 26 typeⅢ. All patients were randomly assigned to two groups and received surgeries of percutaneous fracture reduction followed by internal fixation with cannulated screws and open reduction followed by internal fixation with titanium plate. They were observed in the follow-ups, and functional evaluation was carried out via Marryland evaluation system. Excellent and good rate of the two methods was calculated, and differences between the two groups were analyzed through statistics. Results Follow-ups were carried out for 60 patients, and the follow-up time was 4-38 months (average 18 months). Clinical effects: among 31 patients who received percutaneous fracture reduction followed by internal fixation with cannulated screws, 18 patients showed excellent foot functions, 6 good, 3 average and 2 unsatisfactory. The excellent and good rate was 83.8%; among 29 patients who received open reduction followed by internal fixation with titanium plate, 18 patients showed excellent foot functions, 6 good, 3 average and 2 unsatisfactory. The excellent and good rate was 82.8%. The differences of the excellent and good rate between the two methods were not statistically significant (x2=0.617,P =0.971>0.05).Conclusion Percutaneous fracture reduction followed by internal fixation with cannulated screws and open reduction followed by internal fixation with titanium plate in the treatment of calcaneal fracture can both achieve favorable effects. Percutaneous fracture reduction followed by internal fixation with cannulated screws is minimally invasive, easy to operate and reliable in fixation. The method is effective in avoiding severe complications, which is a clinically practical and efficient method.