摘要
[目的]介绍闭合复位经皮改良空心撑开螺钉固定跟骨骨折的手术技术和初步临床效果。[方法]对24例跟骨关节内骨折采用闭合复位改良空心撑开螺钉经皮内固定。首先利用传统整骨手法,结合钢针撬拨初步恢复跟骨的长度、宽度及角度,关节面准确复位。经皮置入导针,选择合适改良空心撑开螺钉经皮内固定,利用螺钉的螺纹间距前后差进一步复位骨折。采用张铁良足部功能评分系统对疗效进行评价。[结果]24例(24足)均顺利完成手术并获随访10~25个月。术后无感染病例,骨折均骨性愈合,未发生创伤性关节炎等并发症。按张铁良足部功能评分系统评分100分4例,99分7例,97分8例,93分1例,85分2例,69分2例,优良率为91.67%。[结论]闭合复位经皮改良空心撑开螺钉固定跟骨骨折,具有创伤小、并发症少、疗效好等优点。
[Objective]To introduce the surgical technique and preliminary clinical results of closed reduction and percutaneous internal fixation with modified distracting cannulated screws for calcaneal fractures.[Methods]A total of 24 patients received closed reduction and percutaneous internal fixation with modified distracting cannulated screws for calcaneal fractures.Firstly,the length,width and angle of the calcaneus were initially restored by the traditional osteopath technique combined with needle prying,and the articular surface was accurately reduced.As two guide pins were inserted percutaneously,two suitable modified distracting cannulated screws were selected and inserted following the guide pins for percutaneous fixation,which further reduced the fracture compression by the anteroposterior thread spacing difference of the screws.Zhang Tie-liang foot function scoring system was used to evaluate the outcomes.[Results]All 24 patients(24feet)had operation performed successfully,and were followed up for 10~25 months.No complications,such as infection,bone nonunion and traumatic arthritis were found in anyone of them.According to Zhang Tie-liang foot function scoring,4 cases were marked of 100points,7 of 99 points,8 of 97 points,1 of 93 points,2 of 85 points,and 2 cases of 69 points.The excellent and good rate was of 91.67%.[Conclusion]The closed reduction and percutaneous internal fixation with modified distracting cannulated screw for calcaneal fractures have the advantages of less trauma,fewer complications and good curative outcomes.
作者
吴红军
侯仁平
迟涛胜
于满秋
毕宏政
WU Hong-jun;HOU Ren-ping;CHI Tao-sheng;YU Man-qiu;BI Hong-zheng(Shandong Institute of Traumatic Orthopaedics,Wendeng Osteopathic Hospital,Weihai 264400,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2022年第18期1693-1696,共4页
Orthopedic Journal of China
基金
山东省中医药科技发展计划项目(编号:2019-0790)
齐鲁医派中医学术流派传承项目(编号:鲁卫函[2020]132号)。
关键词
跟骨骨折
闭合复位
经皮内固定
空心撑开螺钉
calcaneal fracture
closed reduction
percutaneous internal fixation
distracting cannulated screw
