中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2009年
11期
1011-1015
,共5页
夏胜利%王子平%王秀会%陆耀刚%王惠中%吴祖明%朱汉光%付备刚%崔崟%马晓辉
夏勝利%王子平%王秀會%陸耀剛%王惠中%吳祖明%硃漢光%付備剛%崔崟%馬曉輝
하성리%왕자평%왕수회%륙요강%왕혜중%오조명%주한광%부비강%최음%마효휘
跟骨%关节内骨折%骨折固定术%内%钢板
跟骨%關節內骨摺%骨摺固定術%內%鋼闆
근골%관절내골절%골절고정술%내%강판
Calcaneus%Intra-articular fractures%Fracture fixation,internal%Plate
目的 研制一种适合于经跗骨窦切口经皮插入式的跟骨微创钢板,探讨其在移位性跟骨关节内骨折治疗中的疗效. 方法 自2006年9月至2008年9月经跗骨窦切口入路,采用跟骨经皮插入式钢板治疗跟骨关节内骨折38例(40足),其中SandersⅡ型22足(Ⅱa型6足,Ⅱb型14足,Ⅱc型2足),Ⅲ型18足(Ⅲab型7足,Ⅲac型10足,Ⅲbc型1足).根据X线片对手术前后跟骨高度、宽度、长度及跟骨Bohlers角和Gissanes角进行比较分析,并观察术后切口愈合情况.采用Maryland足部评分系统评价临床功能疗效. 结果 所有患者术后获得3～24个月(平均12个月)随访,X线片示术后跟骨高度、宽度、长度及跟骨Bohlers角和Gissanes角均获得满意矫正,与术前比较,差异均有统计学意义(P<0.01).Maryland足部评分系统显示:优32足,良6足,可2足,优良率95.0%.术后未发现明显并发症. 结论 采用经跗骨窦切口跟骨插入式钢板治疗跟骨关节内移位性骨折不仅可以获得满意的疗效,而且能够有效避免术后并发症的发生.
目的 研製一種適閤于經跗骨竇切口經皮插入式的跟骨微創鋼闆,探討其在移位性跟骨關節內骨摺治療中的療效. 方法 自2006年9月至2008年9月經跗骨竇切口入路,採用跟骨經皮插入式鋼闆治療跟骨關節內骨摺38例(40足),其中SandersⅡ型22足(Ⅱa型6足,Ⅱb型14足,Ⅱc型2足),Ⅲ型18足(Ⅲab型7足,Ⅲac型10足,Ⅲbc型1足).根據X線片對手術前後跟骨高度、寬度、長度及跟骨Bohlers角和Gissanes角進行比較分析,併觀察術後切口愈閤情況.採用Maryland足部評分繫統評價臨床功能療效. 結果 所有患者術後穫得3～24箇月(平均12箇月)隨訪,X線片示術後跟骨高度、寬度、長度及跟骨Bohlers角和Gissanes角均穫得滿意矯正,與術前比較,差異均有統計學意義(P<0.01).Maryland足部評分繫統顯示:優32足,良6足,可2足,優良率95.0%.術後未髮現明顯併髮癥. 結論 採用經跗骨竇切口跟骨插入式鋼闆治療跟骨關節內移位性骨摺不僅可以穫得滿意的療效,而且能夠有效避免術後併髮癥的髮生.
목적 연제일충괄합우경부골두절구경피삽입식적근골미창강판,탐토기재이위성근골관절내골절치료중적료효. 방법 자2006년9월지2008년9월경부골두절구입로,채용근골경피삽입식강판치료근골관절내골절38례(40족),기중SandersⅡ형22족(Ⅱa형6족,Ⅱb형14족,Ⅱc형2족),Ⅲ형18족(Ⅲab형7족,Ⅲac형10족,Ⅲbc형1족).근거X선편대수술전후근골고도、관도、장도급근골Bohlers각화Gissanes각진행비교분석,병관찰술후절구유합정황.채용Maryland족부평분계통평개림상공능료효. 결과 소유환자술후획득3～24개월(평균12개월)수방,X선편시술후근골고도、관도、장도급근골Bohlers각화Gissanes각균획득만의교정,여술전비교,차이균유통계학의의(P<0.01).Maryland족부평분계통현시:우32족,량6족,가2족,우량솔95.0%.술후미발현명현병발증. 결론 채용경부골두절구근골삽입식강판치료근골관절내이위성골절불부가이획득만의적료효,이차능구유효피면술후병발증적발생.
Objective To design a minimally invasive and percutaneous plate for treatment of dis-placed intra-articular calcaneal fractures using a sinus tarsi approach, and explore its clinical therapeutic ef-fects. Methods We designed the minimally invasive and percutaneous plate for treatment of displaced intra-articular calcaneal fractures according to characteristics of anatomic structure of calcaneus and sinus tarsi approach. Between September 2006 and September 2008, 40 intra-articular calcaneal fractures in 38 patients were treated with the self-designed percutaneous plates via sinus tarsi approach under the C-arm image in-tensifier monitor. There were 22 type Ⅱ and 18 type Ⅲ fractures according to Sanders classification system. Pre- and postoperatively, radiographic evaluation was done to determine the calcaneal anatomical parameters, including height, width, length, Bohlers angle and Gissanes angle. Observation of lateral wound healing was performed and clinical functional outcomes were graded using the Maryland foot score system. Results All patients were followed up for an average of 12 (range, 3 to 24) months. Lateral roentgenograms showed satis-factory restoration of the calcaneal height, width, length, Bohlers angle and Gissanes angle. Maryland foot scores demonstrated excellent results in 32 cases, good in 6, and fair in 2, with an excellent to good rate of 95.0%. Postoperative complications were not found in all the fractured feet. Conclusions Sinus tarsi approach used for reduction and internal fixation of displaced intra-articular calcaneal fractures with our percutaneous plate can not only achieve satisfactory therapeutic effects, but also significantly avoid surgical complications.
