摘要
目的对Sanders分型Ⅱ型以上跟骨关节内骨折使用改良内固定方法(A组)和一般内固定方法(B组)两种不同的手术方式进行前瞻性对比研究。方法对36例Sanders分型Ⅱ型以上的跟骨关节内骨折按就诊时间及自主选择固定方法分为A组(19例)及B组(17例)。A组于X线下行撬拨复位,显露跟骨后不做任何复位动作,给予解剖型钢板内固定;B组为传统切复内固定术。对两组手术的手术时间、失血量、切口长度、植骨例数及手术前后的Maryland足部评分和影像学测量数据进行随访和比较。结果两组患者手术时间、植骨例数比较差异无统计学意义(P>0.05),失血量、切口长度差异均有统计学意义(P<0.05),两组患者术后第l天VAS疼痛评分差异有统计学意义(P<0.05),切口愈合情况两组差异有统计学意义(P<0.05)。两组患者Maryland足部评分中功能和疼痛均无统计学意义(P>0.05),两组末次随访时影像学结果差异无统计学意义(P>0.05)。结论改良内固定与一般切开复位内固定治疗跟骨关节内骨折的总体疗效相当,但改良内固定有切口较小、手术创伤小、切口并发症较低的优点。
Objective To make a prospective and comparative study on the application of two different treatments for Sanders type II - m calcaneal fracture, group A with modified internal fixation and group B with internal fixation. Methods 36 cases of Sanders type II -III calcaneal fracture were divided into two groups by visit time and self-determined option of fixation methods. Group A （19cases） was treated by X-ray reduction, and the calcaneal bones were free of fixation after expose and internal fixation with locking proximal humeral plate. Group B （17cases） was treated by traditional fixation. The operation time, bleeding volume, length of incision, number of bone grafting cases, Maryland Foot Score and imaging measure- ment data before and after the treatment of the two groups were observed and followed up. Results There was no significant difference between the two groups on the treatment time and bone grafting cases （P〉O.05）; with a significant difference of bleeding volume and length of incision between the two groups （P〈0.05）; There was significant difference in visual analog scale （VAS） of pain between the two groups on the first day after treatment （P〈0.05）; There was significant difference in incision healing between the two groups （P〈0.05）; The Maryland Foot Scores were of no significance in both groups （p〉0.05）. There was no significant difference between the two groups on imaging measurement values at the time of the latest follow-up （P〉0.05）. Conclusion The total effect of modified internal fixation was almost same to that of open reduction and internal fixation in the treatment of alcaneal fracture, and modified internal fixation has advantages of smaller incision, less trauma and lower complications.
出处
《浙江创伤外科》
2012年第4期439-442,共4页
Zhejiang Journal of Traumatic Surgery
关键词
跟骨骨折
撬拨复位
切开复位
植骨
Calcaneal fracture
Poking reduction
Open reduction
Bone grafting
