| 单侧外固定支架结合有限内固定治疗跟骨关节内骨折 |
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投稿时间：2013-06-08
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| 作者 | Author | 单位 | Address | E-Mail |
| 柴雷子 |
XUE Feng |
上海市交通大学附属第六人民医院南院, 上海 201499 |
Department of Orthopaedics, Southern Branch of the Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 201499, China |
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| 薛锋 |
CHAI Lei-zi |
上海市交通大学附属第六人民医院南院, 上海 201499 |
Department of Orthopaedics, Southern Branch of the Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 201499, China |
xuemd@yahoo.com.cn |
| 肖海军 |
XIAO Hai-jun |
上海市交通大学附属第六人民医院南院, 上海 201499 |
Department of Orthopaedics, Southern Branch of the Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 201499, China |
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| 丁亮 |
DING Liang |
上海市交通大学附属第六人民医院南院, 上海 201499 |
Department of Orthopaedics, Southern Branch of the Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 201499, China |
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| 沈玉春 |
SHEN Yu-chun |
上海市交通大学附属第六人民医院南院, 上海 201499 |
Department of Orthopaedics, Southern Branch of the Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 201499, China |
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| 赵勇 |
ZHAO Yong |
上海市交通大学附属第六人民医院南院, 上海 201499 |
Department of Orthopaedics, Southern Branch of the Sixth People's Hospital of Shanghai Jiaotong University, Shanghai 201499, China |
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| 期刊信息：《中国骨伤》2013年，第26卷，第11期，第889-893页 |
| DOI：10.3969/j.issn.1003-0034.2013.11.002 |
| 基金项目:上海市卫生局课题(编号:2007045) |
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中文摘要:
目的：探讨单侧外固定支架结合空心钉有限内固定治疗跟骨关节内骨折的临床疗效。
方法：2007年5月至2012年2月，采用单侧外固定支架结合空心钉有限内固定治疗52例（58足）跟骨关节内骨折患者，其中男45例（51足），女7例（7足）；年龄18～64岁，平均36.5岁；受伤至手术时间4～13 d，平均（6.2±0.8） d.根据Sanders分型：Ⅱ型36例（40足），Ⅲ型13例（15足），Ⅳ型3例（3足）.患足术前均行跟骨轴、侧位X线片及CT扫描。测量手术前后跟骨Böhler角、Gissane角、长度、高度和宽度。采用Maryland足部评分系统进行功能评估。
结果：52例（58足）中51例（57足）获得随访，时间5～16个月，平均7.2个月。跟骨Böhler角术前（12.65±5.32）°与术后（30.63±4.28）°比较差异有统计学意义（P<0.05）；术前Gissane角（129.87±6.25）°与术后（122.11±4.89）°比较差异有统计学意义（P<0.05）；跟骨长度、宽度及高度术前分别为（64.5±7.1） mm、（34.6±5.7） mm、（30.2±5.2） mm，术后分别为（71.3±5.7） mm、（28.2±6.1） mm、（39.3±6.4） mm，术后与术前比较差异有统计学意义（P<0.05）.采用Maryland评分系统评估足部功能：优20足，良31足，可4足，差2足。3足因手术发生皮缘坏死，经清创、换药后获得愈合。
结论：单侧外固定支架结合有限内固定治疗跟骨关节内骨折具有损伤小、并发症少、功能恢复好等优点，近期疗效满意。 |
| 【关键词】跟骨 骨折 骨折固定术,内 外固定器 |
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| Treatment of intra-articular calcaneal fractures with unilateral external fixator combined with limited internal fixation |
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ABSTRACT
Objective: To study the clinical effects of the unilateral external fixator combined with limited internal fixation such as cannulated lag screws for the treatment of intra-articular calcaneal fractures.
Methods: From May 2007 to February 2012,52 patients (58 feet) with intraarticular calcaneal fractures were treated with unilateral external fixator and limited internal fixation such as lag screws. Forty-five patients (51 feet) were male,7 patients (7 feet) were female,ranging in age from 18 to 64 years,averaged 36.5 years. Time from injury to surgery was 4 to 13(6.2±0.8) days. According to Sanders classification,there were 36 cases (40 feet) with type Ⅱ fractures,13 cases (15 feet) with type Ⅲ fractures,3 cases (3 feet) with type Ⅳ fractures. All patients were examed with X-ray and CT. Böhler angle,Gissane angle,length,width,height were measured on the radiographs,respectively. The function of the feet was assessed by the Maryland grading system.
Results: Fifty-one patients(57 feet) were followed up for 5 to 16 months,with an average of 7.2 months. Calcaneal Böhler angle increased from (12.65±5.32)°preoperatively to (30.63±4.28)° postoperatively. The calcaneal Gissane angle decreased from (129.87±6.25)° preoperatively to (122.11±4.89)° postoperatively. The calcaneal length increased from (64.5±7.1) mm preoperatively to (71.3±5.7) mm postoperatively. The calcaneal width decreased from (34.6±5.7) mm preoperatively to (28.2±6.1) mm postoperatively. The calcaneal height increased from (30.2±5.2) mm preoperatively to (39.3±6.4) mm postoperatively. All of the comparison between preoperative and postoperative measurements revealed statistically significant (P<0.05). The length,width,height,Böhler angle and Gissane angle were improved significantly (P<0.05). According to the Maryland grading system,the result was excellent in 20 feet,good in 31 feet,fair in 4 feet,pour in 2 feet,excellent and good rate was 89.5%. Three feet with wound infection or flap necrosis were healed after wound debridement and dressing exchange.
Conclusion: The unilateral external fixation combined with limited internal fixation is a satisfactory treatment for intra-articular calcaneal fractures in short term with less damage,few complications and good functional recovery. |
| KEY WORDS Calcaneus Fractures Fracture fixation,internal External fixators |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 柴雷子,薛锋,肖海军,丁亮,沈玉春,赵勇.单侧外固定支架结合有限内固定治疗跟骨关节内骨折[J].中国骨伤,2013,26(11):889~893 |
| 英文格式: | XUE Feng,CHAI Lei-zi,XIAO Hai-jun,DING Liang,SHEN Yu-chun,ZHAO Yong.Treatment of intra-articular calcaneal fractures with unilateral external fixator combined with limited internal fixation[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(11):889~893 |
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