不同内固定方法治疗跟骨关节内骨折临床疗效比较.docVIP

不同内固定方法治疗跟骨关节内骨折的临床疗效比较 　　【摘要】 目的：比较克氏针内固定和解剖型钢板内固定治疗跟骨关节内骨折的效果。方法：我院2008年1月-2010年1月共收治跟骨关节内骨折患者120例131足，依据Sanders分型，采用克氏针固定、解剖型钢板内固定进行手术内固定，比较两种内固定方式的疗效和并发症情况。结果：Sanders分型I型、Ⅱ型中，采用克氏针固定和解剖型钢板内固定疗效基本相同，组间比较无统计学意义（P0.05）；Sanders分型Ⅲ型，两种手术方式疗效比较差异显著（P0.05），Ⅳ型两种手术方式疗效比较差异具有极显著性（P0.01）。结论：对于跟骨关节内骨折Sanders I型、Ⅱ型患者采用两种固定方式均能取得良好的临床效果，但克氏针内固定操作更加简便、经济、创伤小，风险低，建议使用；对于SandersⅢ和Ⅳ型复杂跟骨关节内骨折的治疗，解剖钢板内固定的疗效好于克氏针内固定。 　　【关键词】 跟骨关节内骨折；克氏针内固定；钢板内固定 　　 　　Different internal fixation of intraarticular calcaneal fractures compared the clinical efficacy 　　Yuling Qi 　　（Shuangliu County, Sichuan Province, Sichuan Province Peoples Hospital, the second double 610213） 　　【Abstract】Objective：To compare the Kirschner wire fixation and plate fixation with anatomic intra-articular calcaneal fractures. Method：in our hospital in January 2008 on January -2010 intraarticular calcaneal fractures were treated in 120 patients with 131 feet, according to Sanders classification, the use of Kirschner wire fixation, anatomical plate fixation surgery were compared in fixation efficacy and complications. The Ｒesults：of Sanders type I-type, Ⅱ type, the use of Kirschner wire fixation and anatomic fixation is basically the same effect, no significant difference between groups (P 0.05); Sanders type Ⅲ and efficacy of two surgical methods significant difference (P0.05), Ⅳ-type effect of two surgical methods, the difference being very significant (P0.01). Conclusion：For the intra-articular calcaneal fractures Sanders I-type, Ⅱ-type fixation in two patients could achieve good clinical results, but pinning the operation more convenient, economic, trauma, low-risk, is recommended; for Sanders Ⅲ and Ⅳ complex intra-articular calcaneal fractures, anatomical plate fixation is effective in pinning. 　　【Key words】intra-articular calcaneal fractures; Kirschner wire fixation; plate fixation 　　 　　跟骨骨折为最常见的跗骨骨折，约占全身骨折的2%，占跗骨骨折的60%[1]。目前仍对各治疗方法的优劣争论不休，单纯的克氏针内固定，还是采用解剖钢板内固定仍是争论的焦点[2]。本文针对这个问题，对我院2008年1月-2010年1月收治的跟骨关节内骨折患