跗骨窦小切口撬拨复位克氏针内固定治疗Sanders Ⅲ型跟骨骨折
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作者Author单位AddressE-Mail
戴锋 DAI Feng 南京中医药大学附属苏州市中医医院骨科, 江苏 苏州 215001 Department of Orthopedics, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215001, Jiangsu China 497413118@qq.com 
俞鹏飞 YU Peng-fei 南京中医药大学附属苏州市中医医院骨科, 江苏 苏州 215001 Department of Orthopedics, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215001, Jiangsu China  
姜宏 JIANG Hong 南京中医药大学附属苏州市中医医院骨科, 江苏 苏州 215001 Department of Orthopedics, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215001, Jiangsu China  
期刊信息:《中国骨伤》2017年,第30卷,第12期,第1080-1083页
DOI:10.3969/j.issn.1003-0034.2017.12.002
基金项目:
中文摘要:

目的:探讨跗骨窦小切口撬拨复位克氏针内固定治疗Sanders Ⅲ型跟骨骨折的疗效。

方法:自2013年9月至2015年12月采用跗骨窦小切口撬拨复位克氏针固定治疗Sanders Ⅲ型跟骨骨折患者22例,均为单足,其中男18例,女4例;年龄20~65(41.73±12.46)岁。观察并比较手术前后Böhler角、Gissane角及跟骨宽度的变化,术后12个月采用Maryland足部功能评分系统进行疗效评价,记录相关并发症。

结果:所有患者获随访18~36(27.05±4.92)个月;患者骨折均正常愈合,愈合时间(10.73±1.24)周。Böhler角由术前的(11.36±5.92)°恢复到术后的(33.36±3.99)°,差异有统计学意义(P<0.001);Gissane角术前(99.23±8.61)°与术后(114.64±6.93)°比较差异有统计学意义(P<0.001);跟骨宽度由术前(46.59±1.40)mm恢复至术后3个月的(42.15±0.75)mm,差异有统计学意义(P<0.001);术后12个月Maryland足部功能评分为95.05±6.86,优16例,良5例,差1例。患者术后无切口感染、皮缘坏死及骨髓炎发生。

结论:跗骨窦小切口撬拨复位克氏针内固定治疗Sanders Ⅲ型跟骨骨折疗效满意,具有手术创伤小、操作简单、跟距后关节面暴露充分、易于取出、切口并发症少等优点。同时,跗骨窦小切口术中需仔细操作辨认,保护腓肠神经、肌腱。
【关键词】跟骨  骨折  骨折固定术,内
 
Percutaneous reduction and Kirschner pin flxation through sinus tarsi approach for the treatment of Sanders type Ⅲ calcaneal fracture
ABSTRACT  

Objective: To investigate clinical effect of percutaneous reduction and Kirschner pin flxation through sinus tarsi approach in treating Sanders type Ⅲ calcaneal fracture.

Methods: Totally 22 patients (22 feet) with Sanders Ⅲ calcaneal fracture were treated with percutaneous reduction and Kirschner pin flxation through sinus tarsi approach form September 2013 to December 2015. Among them,including 18 males and 4 females;aged from 20 to 65 years old with an average of (41.73±12.46) years old. Böhler angle,Gissane angle and calcaneal width before and after operation were observed and compared,Maryland scoring system was used to evaluate curative effect;postoperative complications were recorded.

Results: All patients were followed up from 18 to 36 months with an average of (27.05±4.92) months. All fractures healed well with an average of (10.73±1.24) weeks. Böhler angle before operation (11.36±5.92) improved to (33.36±3.99) after operation,and had significant differences(P<0.05);there was significant difference of Gissane angle between preoperation (99.23±8.61) and postoperation (114.64±6.93); calcaneal width was improved from (46.59±1.40) mm before operation to (42.15±0.75) mm at 3 months after operation (P<0.05). Maryland score was (95.05±6.86) points,16 patients obtained excellent results,5 patients moderate,and 1 patient poor. No inflammation,flap margin necrosis and osteomyelitis occurred.

Conclusion: Compared with conventional internal fixation through L-shape incision,percutaneous reduction and Kirschner pin flxation through sinus tarsi approach in treating Sanders type Ⅲ calcaneal fracture obtained satisfied clinical effects,and has advantages of invasive trauma,simple operation,easy to remove and less complication. Meanwhile,careful operation and identification should be done during sinus tarsi approach operation to protect sural nerve and tendon.
KEY WORDS  Calcaneus  Fractures  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:戴锋,俞鹏飞,姜宏.跗骨窦小切口撬拨复位克氏针内固定治疗Sanders Ⅲ型跟骨骨折[J].中国骨伤,2017,30(12):1080~1083
英文格式:DAI Feng,YU Peng-fei,JIANG Hong.Percutaneous reduction and Kirschner pin flxation through sinus tarsi approach for the treatment of Sanders type Ⅲ calcaneal fracture[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(12):1080~1083
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