摘要
目的探讨切开撬拨复位结合磷酸钙陶瓷植骨治疗SandersⅡ型跟骨骨折的临床疗效。方法2003年1月～2007年3月,采用切开撬拨复位斯氏针固定并结合磷酸钙陶瓷植骨治疗SandersⅡ型跟骨骨折32例38足,手术前后评价跟骨B hler角,Gissane角、跟骨宽度的改善情况,随访期间观察并发症,采用Maryland评分评价患足功能。结果6例伤口愈合不良,2例术后足背外侧麻痛感,3例斯氏针松动脱出。术前B hler角、Gissane角、跟骨宽度分别为(14.3±5.2)°、(105.3±8.6)°、(39.6±3.4)mm,术后分别为(32.8±3.5)°、(123.2±6.5)°、(32.4±1.6)mm,经统计学分析手术前后差异有显著性(P<0.01)。经平均16个月的随访,按Maryland足功能评分标准:优16例,良12例,可4例,优良率87.5%。结论切开撬拨复位结合磷酸钙陶瓷植骨治疗SandersⅡ型跟骨骨折,可获得良好的复位和固定,仍可作为理想的治疗方法之一。
Objective To investigate the clinical effect of open reduction by leverage and calcium phosphate bioceramic implantation for treatment of Sanders Ⅱ calcaneal fracture. Methods From January 2003 to March 2007, 32 patients （38 feet） were treated with open reduction by leverage and calcium phosphate bioceramic implantation. According to sanders classification, all patients＇ caleaneal fractures were Sanders type Ⅱ . The anatomic reduction of posterior facet, restoration of width, the Bohler angle and Gissane angle after operation were evaluated. During follow - up, complications were observed and the foot function was evaluated by Maryland foot score. Results Xix patients suffered with necrosis of skin and soft tissue. Two patients felt sensory disturbance in lateral foot. Steinmann＇ s pins were pulled out in 3 patients. The preoperative X- ray showed that B6hler angle was （14.3± 5.2）°, Gissane angle was （105.3 ± 8.6）°, and calcaneal width was （39.6 ±3.4） mm. The postoperative X- ray showed that Bohler angle was （32.8 ± 3.5）°, Gissane angle was （123.2 ± 6.5）°, and calcaneal width was （32.4 ± 1.6） mm. There were significant differences before and after operation （P 〈0.01）. By mean 16 months follow- up, according to Maryland foot score, 16 patients were excellent, 12 were good, and 4 were fair. The excellent and good rate was 87.5 %. Conclusion Open reduction by leverage and calcium phosphate bioceramic implantation is one of the ideal treatment methods for Sanders Ⅱ calcaneal fracture. It can obtain good reduction and stable fixation with the lower complications.
出处
《中国骨与关节损伤杂志》
2008年第10期828-830,共3页
Chinese Journal of Bone and Joint Injury
关键词
跟骨骨折
撬拨复位
磷酸钙生物陶瓷
内固定
Calcaneal fracture
Reduction by leverage
Calcium phosphate bioceramic
Internal fixation
