| 闭合复位内固定与经跗骨窦小切口内固定治疗SandersⅡ型跟骨骨折的疗效比较 |
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投稿时间：2019-02-11
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| 作者 | Author | 单位 | Address | E-Mail |
| 崔树廷 |
CUI Shu-ting |
聊城市第二人民医院骨科, 山东 聊城 252600 |
Department of Orthopaedics, the Second People's Hospital of Liaocheng, Liaocheng 252600, Shandong, China |
cuishuting1999@163.com |
| 刘子祯 |
LIU Zi-zhen |
聊城市第二人民医院骨科, 山东 聊城 252600 |
Department of Orthopaedics, the Second People's Hospital of Liaocheng, Liaocheng 252600, Shandong, China |
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| 汤斌 |
TANG Bin |
聊城市第二人民医院骨科, 山东 聊城 252600 |
Department of Orthopaedics, the Second People's Hospital of Liaocheng, Liaocheng 252600, Shandong, China |
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| 陈光鑫 |
CHEN Guang-xin |
聊城市第二人民医院骨科, 山东 聊城 252600 |
Department of Orthopaedics, the Second People's Hospital of Liaocheng, Liaocheng 252600, Shandong, China |
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| 王志震 |
WANG Zhi-zhen |
聊城市第二人民医院骨科, 山东 聊城 252600 |
Department of Orthopaedics, the Second People's Hospital of Liaocheng, Liaocheng 252600, Shandong, China |
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| 期刊信息：《中国骨伤》2019年，第32卷，第5期，第448-453页 |
| DOI：10.3969/j.issn.1003-0034.2019.05.012 |
| 基金项目: |
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中文摘要:
目的：比较闭合复位内固定和经跗骨窦有限切口内固定治疗SandersⅡ型跟骨骨折的临床疗效。
方法：自2015年6月至2018年2月采用微创方法治疗SandersⅡ型跟骨骨折患者60例，根据治疗方法的不同分为两组：闭合撬拨复位空心钉内固定组（A组）和经跗骨窦有限切口内固定组（B组）。其中A组34例，男22例，女12例，年龄21~60（38.90±3.25）岁，Sanders ⅡA型14例，ⅡB型14例，ⅡC型6例；B组20例，男14例，女6例，年龄20~59（39.20±2.96）岁，Sanders ⅡA型8例，ⅡB型9例，ⅡC型3例。手术前后分别测量跟骨的跟骨高度、跟骨宽度、Gissane角、Bohler角，并对手术并发症、住院时间及花费进行对比，术后1年采用美国足踝骨科协会（AOFAS）评分系统进行功能评估。
结果：术后54例获得随访，时间6~16（11.40±2.55）个月，失访6例。患者术后伤口均甲级愈合，无皮肤感染、坏死等伤口并发症发生；其中A组神经损伤1例，肌腱卡压2例，B组神经损伤2例，差异无统计学意义（P>0.05）。A组跟骨宽度、高度、Bohlers角及Gissane角的矫正情况与B组比较差异无统计学意义（P>0.05）。A组术后AOFAS评分（89.2±4.7）分与B组（88.7±4.8）分比较差异无统计学意义（P>0.05）。住院花费及住院时间A组分别为（5 021.25±1 047.19）元、（6.31±4.75）d，B组分别为（13 591.35±1 975.21）元、（9.65±3.42）d，差异有统计学意义（P<0.05）。
结论：闭合复位内固定与经跗骨窦切口复位内固定对SandersⅡ型骨折疗效相当，具有创伤小、并发症少等优点，闭合复位空心钉固定能明显缩短住院时间，降低住院费用，经济性高，但应注意避免选择粉碎严重的跟骨骨折。 |
| 【关键词】跟骨 骨折 骨折闭合复位 跗骨窦 骨折固定术,内 |
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| Closed reduction and internal fixation versus transtarsal sinus small incision internal fixation for Sanders typeⅡcalcaneal fractures |
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ABSTRACT
Objective:To compare the clinical effects of closed reduction and internal fixation with limited transtarsal sinus incision in the treatment of Sanders typeⅡcalcaneal fractures.
Methods:From June 2015 to February 2018,60 patients with Sanders typeⅡcalcaneal fractures were treated by minimally invasive method. According to the different treatment methods,they were divided into two groups:closed prying reduction and internal fixation with hollow nails(group A) and limited transtarsal sinus incision internal fixation (group B). There were 34 cases in group A,including 22 males and 12 females,aged 21 to 60(38.90±3.25) years old,14 cases of Sanders typeⅡA,14 cases of Sanders typeⅡB and 6 cases of Sanders typeⅡC. There were 20 cases in group B,including 14 males and 6 females,aged 20 to 59(39.20±2.96) years old,8 cases of Sanders typeⅡA,9 cases of Sanders typeⅡB and 3 cases of Sanders typeⅡC. Calcaneal height,calcaneal width,Gissane angle and Bohler angle were measured before and after operation. The complications,hospitalization time and cost were compared. Functional evaluation was performed by AOFAS score system one year after operation.
Results:Fifty-four cases were followed up for 6 to 16(11.40±2.55) months and 6 cases were lost. All the wounds healed in grade A without complications such as skin infection and necrosis. There were 1 case of nerve injury in group A,2 cases of tendon entrapment,2 cases of nerve injury in group B,there was no significant difference(P>0.05). There was no significant difference in calcaneal width,height,Bohlers angle and Gissane angle between group A and group B (P>0.05). There was no significant difference in AOFAS score between group A and group B(89.2±4.7 vs 88.7±4.8,P>0.05). The hospitalization expenditure and length of stay in group A were(5 021.25±1 047.19) yuan,(6.31±4.75) d,and those in group B were(13 591.35±1 975.21) yuan,(9.65±3.42) d,respectively,with significant difference(P<0.05).
Conclusion:Closed reduction and internal fixation is as effective as transtarsal sinus incision reduction and internal fixation for Sanders typeⅡfracture. It has the advantages of less trauma and fewer complications. Closed reduction and hollow nail fixation group can significantly shorten hospitalization time,reduce hospitalization costs,and is more economical. It is worth recommending,but attention should be paid to avoid choosing to comminute serious calcaneal fracture. |
| KEY WORDS Calcaneus Fractures Closed fracture reduction Sinus tarsi Fracture fixation,internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 崔树廷,刘子祯,汤斌,陈光鑫,王志震.闭合复位内固定与经跗骨窦小切口内固定治疗SandersⅡ型跟骨骨折的疗效比较[J].中国骨伤,2019,32(5):448~453 |
| 英文格式: | CUI Shu-ting,LIU Zi-zhen,TANG Bin,CHEN Guang-xin,WANG Zhi-zhen.Closed reduction and internal fixation versus transtarsal sinus small incision internal fixation for Sanders typeⅡcalcaneal fractures[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(5):448~453 |
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