摘要
目的探讨微创空心螺钉治疗跟骨骨折的治疗效果与可行性。方法回顾性分析2013年7月至2014年7月间的47例跟骨骨折患者,男35例,女12例,年龄(33.9±6.3)岁。切开复位内固定术组22例,男17例,女5例,Sanders分型:Ⅱ型16例,Ⅲ型4例,Ⅳ型2例。微创空心钉组25例,男18例,女7例,Sanders分型:Ⅱ型22例,Ⅲ型2例,Ⅳ型1例。对比分析两组患者的Maryland评分、术后并发症、手术花费、住院日、手术时间、生化指标(TRACP 5b和CTX)及Bolher角和Gissane角的恢复情况。结果所有患者均获得6个月的随访,微创空心钉组患者住院日[(9.5±1.2)d,t=5.666,P<0.001)]、手术花费[(12 310.6±824.8)元,t=8.662,P<0.001]及手术时间[(74.1±10.8)min,t=4.374,P<0.001]与切开复位组[(12.1±1.79)d;(15 287.4±1 414.2)元;(87.6±10.2)min]相比差异有统计学意义(P<0.05),两组患者术后Maryland评分优良率(77.27%比84.00%,χ~2=0.342,P=0.715)、术后并发症(P=0.593)、抗酒石酸酸性磷酸酶5 b[(3.53±0.29)U·L^(-1)比(3.56±0.30)U·L^(-1),t=0.347,P=0.730]、Ⅰ型胶原蛋白羧基端肽[(553.88±32.14)μg·L^(-1)比(556.11±16.80)μg·L^(-1),t=0.291,P=0.772]及Bolher角(29.84°±1.83°比29.91°±1.91°,t=0.127,P=0.899)和Gissane角(132.85°±5.41°比134.37°±4.92°,t=1.008,P=0.318)的恢复情况比较,差异无统计学意义(P>0.05)。结论对于SandersⅡ型及SandersⅢ型骨折,微创空心螺钉与传统术式疗效相当,且具有操作简便、经济、创伤较小、耗时较短等优点。
Objective To investigate the effect and the viability of minimally invasive for calcaneal fractures with cannulated screw fixation. Methods We selected a total of 47 calcaneal fracture patients（ 35 males and 12 females,average age 33. 9 ± 6. 3 years old）from July 2013 to July 2014. According to Sanders classification,in the plate fixation group（ 17 males and 5 females）,16 cases belong to typeⅡ,4 cases belong to type Ⅲ,2 cases belong to type Ⅳ. In the cannulated screw fixation group（ 18 males and 7 females）,22 cases belong to typeⅡ,2 cases belong to type Ⅲ,1 cases belong to type Ⅳ. We compare and retrospective analysis about the therapeutic outcomes,post-operation complications,cost effectiveness,operative time,the level of TRACP 5 b and CTX,Bolher angle and Gissane angle of these patients. Results All case were follow-up for 6 months. The hospital stay（ 9. 5 ± 1. 2 d,t = 5. 666,P〈0. 001）,surgery cost（ 12 310. 6 ± 824. 2 RMB,t = 8. 662,P〈0. 001） and operative time（ 74. 1 ± 10. 8 min,t = 4. 374,P〈0. 001） in cannulated screw fixation group are better than the plate fixation group（ 12. 1 ± 1. 8 d; 15 287. 4 ± 1 414. 2 RMB; 87. 6 ± 10. 2 min; P〈0. 05）. However,in therapeutic outcomes（ 77. 27% vs. 84. 00%,χ^2= 0. 342,P = 0. 715）,post-operation complications（ P = 0. 593）,the level of TRACP 5 b（ 3. 53 ± 0. 29 U·L^-1 vs. 3. 56 ± 0. 30 U·L^-1,t = 0. 347,P = 0. 730） and CTX（ 553. 88 ± 32. 14μg·L^-1 vs.556. 11 ± 16. 80μg·L^-1,t = 0. 291,P = 0. 772）,Bolher angle（ 29. 84° ± 1. 83°vs. 29. 91° ± 1. 91°,t = 0. 127,P = 0. 899） and Gissane angle（ 132. 85° ± 5. 41° vs. 134. 37° ± 4. 92°,t = 1. 008,P = 0. 318）,there are no significant difference between the cannulated screw fixation group and the plate fixation group（ P〈0. 05）. Conclusions For the Sanders Ⅱ and Ⅲ pattern calcaneal fractures,minimally invasive for calcaneal fractures with cannulated screw fixation is a simple and high cost effectiveness method of the calcane
作者
黄冠予
彭昊
HUANG Guanyu;PENG Hao(Department of Orthopaedics,Renmin Hospital,Wuhan University,Wuhan,Hubei 430060,China)
出处
《安徽医药》
CAS
2018年第7期1268-1272,共5页
Anhui Medical and Pharmaceutical Journal
基金
国家自然基金项目(81672154)
关键词
跟骨
骨折
骨钉
外科手术
微创性
骨折固定术
内
治疗结果
Calcaneus
Fractures
bone
Bone nails
Surgical procedures
minimally invasive
Fracture fixation
internal
TreatmentoutconIe
