Nie Wei-zhi, Sun Lei, Yang Mao-qing, Tan Yuan-chao, Zhu Hui-fang
Wendeng Orthopaedic Hospital, Wendeng 264400, Shandong, China.
Zhongguo Gu Shang. 2009 Jan;22(1):1-3.
To compare the effect between mini-traumatic bone-grafting and non-bone-grafting in percutaneous K-wire fixation for treating the calcaneal fractures.
From 2002 to 2006, 112 patients with the type II (Paley type) fractures of calcaneus were studied. There were 56 cases in bone-grafting group involving 36 males and 20 famales,aged from 21 to 65, averaged (42.0 +/- 2.3) years; 11 cases were in type II a and 45 were in type II b; the course was from 3 to 14 days, averaged (6.0 +/- 1.2) days. And there were 56 cases in non-bone-grafting group involving 38 males and 18 famales,aged from 22 to 67, averaged (43.0 +/- 2.5)years; 13 cases were in type II a and 43 were in type II b; the course was from 2 to 15 days, averaged (5.0-2.1) days. All the cases were treated by closed reduction and percutaneous K-wire fixation, and bone-grafting group(56 cases) were treated by mini-traumatic bone-grafting, but the other group (56 cases) were not. The collapsing rate and fineness rate were compared.
All the cases were followed up from 5 to 52 months. There were no collapsing cases in the bone-grafting group after operation, but 3 cases occurrenced re-collapsing in the non-bone-grafting group. According to the Zhang Tie-liang's evaluation criterion, in the bone-grafting group,the results were excellent in 43 cases, good in 12, fair in 1, the fineness rate was 98.2%. In the non-bone-grafting group,the results were excellent in 37 cases, good in 16, fair in 2, poor in 1, the fineness rate was 94.7%.
Treatment of the type II fracture of calcaneus with closed reduction, percutaneous K-wire fixation and mini-traumatic bone-grafting can prevent the posterior talar articular surface of caltaneus from collapsing again after operation, enhance the union of fracture, elevate the curative effect, thus it should be taken with the standard therapeutic regimen.
比较微创植骨与非植骨在经皮克氏针固定治疗跟骨骨折中的效果。
2002年至2006年，对112例Ⅱ型（Paley分型）跟骨骨折患者进行研究。植骨组56例，男36例，女20例，年龄21～65岁，平均（42.0±2.3）岁；Ⅱa型11例，Ⅱb型45例；病程3～14天，平均（6.0±1.2）天。非植骨组56例，男38例，女18例，年龄22～67岁，平均（43.0±2.5）岁；Ⅱa型13例，Ⅱb型43例；病程2～15天，平均（5.0±2.1）天。所有病例均采用闭合复位经皮克氏针固定治疗，植骨组（56例）采用微创植骨，另一组（56例）未植骨。比较两组的塌陷率和优良率。
所有病例随访5～52个月。植骨组术后无塌陷病例，非植骨组有3例发生再次塌陷。根据张铁良评价标准，植骨组优43例，良12例，可1例，优良率为98.2%。非植骨组优37例，良16例，可2例，差1例，优良率为94.7%。
闭合复位、经皮克氏针固定及微创植骨治疗Ⅱ型跟骨骨折可防止跟骨后距关节面术后再次塌陷，促进骨折愈合，提高疗效，应作为标准治疗方案应用。
