切开复位锁定钢板内固定治疗跟骨骨折近期疗效研究-study on short-term effect of open reduction and locking plate internal fixation for calcaneal fracture.docxVIP
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切开复位锁定钢板内固定治疗跟骨骨折近期疗效研究-study on short-term effect of open reduction and locking plate internal fixation for calcaneal fracture
切开复位锁定钢板内固定治疗跟骨骨折近期疗效分析中文摘要目的:探讨跟骨骨折锁定钢板内固定治疗疗效,归纳总结经验。方法:收集我院2012年01月~2014年03月跟骨骨折51例,实际随访32例43足,按Sanders分型:II型18例、Ⅲ型18例、Ⅳ型7例,所有患足均为闭合性骨折,术前及术后测量跟骨侧位片高度、长度、宽度、Bohler角及Gissane角变化,评估骨折复位情况,术前术后按Maryland足部评分系统评估足部功能,并进行t检验。结果:实际随访32例43足,均获随访12个月。末次随访骨折均愈合,平均愈合时间为10-16周,患足功能满意;2例伤口感染,经换药处理后痊愈,1例出现皮肤坏死,经植皮后痊愈,1例距下关节炎引起疼痛,发生在骨性愈合后1年出现患足的疼痛,建议患者再次行关节融合术,术后症状消失;术前术后分别测量SandersII、III、IV型跟骨侧位片高度、长度、宽度、Bohler角及Gissane角并进行t检验,统计数据具有差异性(P<0.05);术前与术后SandersII、III、IV型Maryland评分进行t检验,差异有统计学意义(P<0.05),Maryland评分SandersII型:优10例,良7例,可1例,优良率为94.4%,SandersIII型:优9例,良6例,可3例,优良率为83.3%,SandersIV型:优2例,良3例,可1例,差1例,优良率为71.4%。结论:切开复位锁定钢板内固定治疗跟骨骨折,疗效满意。关键词:跟骨骨折,切开复位内固定,锁定钢板TheanalysisofOpenreductionandplatefixation(ORIFLockingplate)fortreatmentofcalcanealfracturesAbstractOBJECTIVE:Thepurposeofthisstudyistoconcludetheefficiencyofthetreatmentofcalcanealfracturesusinglockingplates,andsumupexiperience.MEHTODS:FromJanuary2012toMarch2014,51patientswithcalcanealfracturesweretreatedwithlockingplatesinZunyiMedicalcollegeAffiliatedHospital,32patientswith43calcanealfracturesachievethefollow-upactually.AccordingtoSandersclassificationsystem,therewere18casesbelongtothetypeII,18casesoftypeIII,andtypeIVwere7,allofthemwereclosedfractures.Inpre-operationandpost-operation,respectielymeasuredthecalcaneals’heigth,length,width,theanlgeofB?hlerandGissaneinthetypesofSandersII、III、IV,andevaluatedtheconditionofthereductionoffratures.Beforeandafteroperation,evaluatingthefunctionofthefootbythescoresystemofMaryland,andtheresultsusedttest.RESULTS:32patientswith43calcanealfracturesachievethefollow-upactually.Allpatientswerefollowedup12monthsonaverage.Allfractureswerehealed,theaveragehealingtimewas10to16weeks,allfeetachievedsatisfactionfunction.2casesoccurwoundinfection,andthewoundwashealedafterdressingtreatment,1caseoccurskinnecrosisandhealedafterskingraft.Inpre-operationandpost-operation,respectielymeasuredSandersII、III、IVcalcaneals’heigth,length,width,theanlgeofB?hlerandGissaneinlateralcalcanealslice,andtheresultsusedtte
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