摘要
目的：探讨经外侧小切口复位后距下关节面,多枚空心螺钉组合内固定治疗跟骨关节内骨折的方法及临床疗效。方法：2010-12-2012-12期间,对我科收治的23例闭合性跟骨关节内骨折患者纳入研究,常规行CT扫描明确骨折类型,根据Sanders分型,其中Ⅱ型19例,Ⅲ型4例,采用经跗骨窦小切口复位后距下关节面,以多枚AO 4.0mm空心螺钉组合内固定的手术方式进行治疗,术后观察切口愈合及并发症情况,复查X片及CT评价骨折复位情况（Bohler角,Gissane角）,并应用美国足踝外科学会AOFAS评分标准评估疗效。结果：其中21例获得术后随访,随访时间12-24个月,平均18个月。切口均一期愈合,1例SandersⅢ型患者末次随访时Bohler角较术后丢失3°,至末次随访时未发现内固定断裂,骨折均在8-12周内获得愈合,平均愈合时间（10.41±0.87）周。AOFAS评分：优12例（Ⅱ型）,良7例（Ⅱ型6例,Ⅲ型1例）,可2例（Ⅲ型）,至末次随访,2例观察到轻度创伤性关节炎征象。结论：采用外侧小切口直视下复位后距下关节面,多枚4.0mm空心螺钉组合内固定治疗简单类型的跟骨关节内骨折,可以获得满意的复位和可靠的固定,明显减少切口并发症。
Objective：To evaluate the surgical technique and clinical outcome of mini-open approach with cannulated screws fixation for intra-articular calcaneal fractures.Method：Twenty-three patients with closed intra-articular calcaneal fractures were treated between Dec 2010and Dec 2012.According to Sanders classification,19cases were typeⅡand 4cases were typeⅢ.All cases were evaluated carefully with X-ray and CT scan preoperatively to define the type and displace of fracture.mini-open lateral approach with 4.0mm cannulated screws fixation was performed.X ray and CT scan were taken in the follow-up.Functional evaluation was carried out according to the Hind-foot Score by American Orthopaedic Foot and Ankle Society（AOFAS）.Complications were also recorded. Result：21patients were followed up with a mean duration of 16.2months（12to 24months）.No complications of wound infection or hardware failure were noted.Bone union was achieved at an average 10.4weeks（8to 12weeks） postoperatively.No hardware failure occurred.Gentle past-traumatic arthritis was noted in two cases.According to AOFAS scores,12cases got excellent results,7good,2fair.Conclusion：Mini-open lateral approach with multiple cannulated screws fixation is an effective treatment for simple type intra-articular calcaneal fractures.In this way satisfactory reduction and stable fixation can be achieved,and soft tissue complications can be limited.
出处
《临床急诊杂志》
CAS
2014年第5期292-295,共4页
Journal of Clinical Emergency
关键词
骨折
手术治疗
骨折固定术
fracture
surgical treatment
fracture fixation
