摘要
目的:分析撬拨复位Ilizarov外固定技术(以下简称Ilizarov技术)在闭合性跟骨关节内移位骨折中的应用价值。方法:回顾性分析2019年1月—2022年3月于福建中医药大学附属人民医院行手术治疗并获得随访的82例闭合性跟骨关节内移位骨折患者的病历资料,根据手术方案不同分为Ilizarov技术组41例和传统外侧“L”形入路切开复位结合钢板内固定术(以下简称开放手术)组41例。其中Ilizarov技术组行Ilizarov技术治疗,开放手术组行开放手术治疗。比较两组手术相关指标;分别于术前及术后1、3、7、14 d采用视觉模拟评分法(VAS)评价患者疼痛情况;分别于术前和术后6个月对两组患者患侧行X线检查,测量Bohler角、Gissane角、跟骨长度和跟骨宽度;分别于术前和术后6个月采用Maryland足部评分系统(MFS)及美国骨科足踝外科协会(AOFAS)评分对两组患侧功能状况进行评价;并记录两组术后并发症发生情况。结果:较之开放手术组,Ilizarov技术组术前等待时间、手术时间、术中出血量及住院时间均显著更优,差异均有统计学意义(P<0.05)。Ilizarov技术组术后1、3、7、14 d的VAS评分均显著低于同期开放手术组,差异均有统计学意义(P<0.05)。较之术前,两组术后6个月患侧Bohler角、Gissane角、跟骨长度均显著增加,跟骨宽度则均显著缩小,差异均有统计学意义(P<0.05);两组患侧跟骨相关参数比较,差异均无统计学意义(P>0.05)。术后6个月,两组患侧MFS、AOFAS评分均较术前显著升高(P<0.05);术后6个月,Ilizarov技术组患侧MFS评分显著高于开放手术组,差异有统计学意义(P<0.05);术后6个月,两组患侧AOFAS评分比较,差异无统计学意义(P>0.05)。Ilizarov技术组术后并发症发生率为4.88%,开放手术组为21.95%,Ilizarov技术组显著低于开放手术组,差异有统计学意义(P<0.05)。结论:Ilizarov技术治疗闭合性跟骨关节内移位骨折能获得与开放手术相�
Objective:To analyze the application value of Ilizarov external fixation technique(Ilizarov technique for short)in closed displaced calcaneal fractures.Method:A retrospective analysis was performed on 82 patients with closed intra-articular calcaneal displaced fractures who underwent surgical treatment in People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2019 to March 2022.According to different surgical plans,41 cases were divided into Ilizarov technique group and traditional"L"approach open reduction combined with plate internal fixation(hereinafter referred to as open surgery)group.The Ilizarov technique group was treated with Ilizarov technique,and the open surgery group was treated with open surgery.Operation-related indexes were compared between the two groups;visual analog scale(VAS)was used to evaluate the pain of patients before surgery and at 1,3,7 and 14 d after surgery.Böhler angle,Gissane angle,calcaneal length and calcaneal width were measured by X-ray examination on the affected side of patients in both groups before and 6 months after surgery;the Maryland foot scoring system(MFS)and American orthopaedic foot and ankle surgery(AOFAS)were used to evaluate the functional status of the affected side before and 6 months after surgery,respectively;postoperative complications was recorded in the two groups.Result:Compared with the open surgery group,the Ilizarov technique group had significantly better preoperative waiting time,operation time,intraoperative blood loss and hospital stay,the differences were statistically significant(P<0.05).The VAS scores of the Ilizarov technique group at 1,3,7 and 14 d after surgery were significantly lower than those of the open surgery group at the same time,the differences were statistically significant(P<0.05).Compared with before surgery,Böhler angle,Gissane angle and calcaneal length on the affected side were significantly increased in both groups 6 months after surgery,while calcaneal width was significantly reduced,
作者
邱华骥
余兰伟
陈妍
刘子文
韩大为
QIU Huaji;YU Lanwei;CHEN Yan;LIU Ziwen;HAN Dawei(People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350004,China;不详)
出处
《中国医学创新》
CAS
2023年第20期20-25,共6页
Medical Innovation of China
基金
福建省教育厅中青年教师教育科研项目(科技类)(JAT190257)。
