CAJ | 학술논문

目的探讨外侧骨皮瓣入路钢板内置治疗移位性跟骨关节内骨折的疗效.方法自2011年1月至2013年1月采用经外侧骨皮瓣入路钢板内置治疗移位性跟骨关节内骨折23例26足,男17例,女6例;年龄18～65岁,平均35.3岁;左侧15足,右侧11足.骨折按照Sanders分型:ⅡA型5足,ⅢAB型8足,ⅢAC型6足,Ⅳ型7足.采用Maryland足部评分评价术后疗效,并观察术后跟骨B(o)hler角、Gissane角、高度、宽度、踝关节活动范围的恢复情况.结果所有患者术后获21 ～45个月(平均26.3个月)随访.术后B(o)hler角(33.0°±7.4°)、Gissane角(121.3°±8.2°)、高度[(39.4±5.2)mm]、宽度[(26.2±3.5) mm]、踝关节活动范围(63.2°±4.3°)较术前[-1.6°±7.6°、144.6°±10.3°、(28.7±4.3) mm、(35.2±3.3)mm、34.1°±4.4°]明显改善,差异均有统计学意义(P＜0.05).按Maryland足部评分评估术后功能:优14足,良10足,可2足,优良率为92.3％.结论经外侧骨皮瓣入路钢板内置固定,具有显露、复位良好、软组织并发症少、功能康复优良的特点,是治疗复杂跟骨骨折的良好选择.
목적 탐토외측골피판입로강판내치치료이위성근골관절내골절적료효.방법 자2011년1월지2013년1월채용경외측골피판입로강판내치치료이위성근골관절내골절23례26족,남17례,녀6례;년령18～65세,평균35.3세;좌측15족,우측11족.골절안조Sanders분형:ⅡA형5족,ⅢAB형8족,ⅢAC형6족,Ⅳ형7족.채용Maryland족부평분평개술후료효,병관찰술후근골B(o)hler각、Gissane각、고도、관도、과관절활동범위적회복정황.결과 소유환자술후획21 ～45개월(평균26.3개월)수방.술후B(o)hler각(33.0°±7.4°)、Gissane각(121.3°±8.2°)、고도[(39.4±5.2)mm]、관도[(26.2±3.5) mm]、과관절활동범위(63.2°±4.3°)교술전[-1.6°±7.6°、144.6°±10.3°、(28.7±4.3) mm、(35.2±3.3)mm、34.1°±4.4°]명현개선,차이균유통계학의의(P＜0.05).안Maryland족부평분평고술후공능:우14족,량10족,가2족,우량솔위92.3％.결론 경외측골피판입로강판내치고정,구유현로、복위량호、연조직병발증소、공능강복우량적특점,시치료복잡근골골절적량호선택.
Objective To evaluate the clinical efficacy of inlayed plate via the lateral bone flap approach for treatment of displaced intra-articular calcaneal fractures.Methods From January 2011 to January 2013,23 patients with displaced intra-articular calcaneal fracture were treated with inlayed plate via the lateral bone flap approach.They were 17 men and 6 women,18 to 65 years of age (mean,35.3 years).The fractures involved 26 feet,on the left in 15 feet and on the right in 11 feet.By Sanders' classification,5 feet were type ⅡA,8 feet type Ⅲ AB,6 feet type Ⅲ AC and 7 feet type Ⅳ.The clinical efficacy was assessed by the Maryland foot scoring system.The B(o)hler's and Gissane's angles,height and width of the calcaneus and the range of motion (ROM) of the ankle were also evaluated postoperatively.Results The patients were followed up for 21 to 45 months (average,26.3 months).The postoperative B(o)hler's angle (33.0° ± 7.4°),Gissane' s angle (121.3° ± 8.2°),height (39.4 ± 5.2 mm),width (26.2 ± 3.5 mm) and ROM (63.2° ± 4.3°) were obviously improved compared to the preoperative ones (-1.6° ± 7.6°,144.6° ±10.3°,28.7 ±4.3 mm,35.2 ±3.3 mm,34.1°±4.4°,respectively).The Maryland foot scoring showed excellent functional recovery in 14 feet,good in 10 feet,and fair in 2 feet,giving an excellent to good rate of 92.3％.Conclusion In the treatment of displaced intra-articular calcaneal fracture,the plate that is implanted via the lateral bone flap approach is a new fixation method with good clinical efficacy because it can lead to good exposure that facilitates fine reduction and fixation,a lower rate of soft tissue complications and good functional recovery.