[用于距骨支撑螺钉置入的导向器辅助与普通螺钉导向器辅助下跟骨载距突固定的比较]

[Comparison of fixation of sustentaculum tali of calcaneus aided by director for sustentaculum tali screwing and ordinary screwing guide].

作者信息

Wang Yun, Liu Bing-Gen, Pang Qing-Jiang, Yu Xiao, Chen Xian-Jun, Guo Zong-Hui

机构信息

Department of Orthopaedics, Ningbo No. 2 Hospital, Ningbo 315010, Zhejiang, China.

Department of Orthopaedics, Ningbo No. 2 Hospital, Ningbo 315010, Zhejiang, China;

出版信息

Zhongguo Gu Shang. 2016 Dec 25;29(12):1097-1103. doi: 10.3969/j.issn.1003-0034.2016.12.007.

DOI:10.3969/j.issn.1003-0034.2016.12.007

PMID:29292883

Abstract

OBJECTIVE

To explore clinical outcomes of director for sustentaculum tali screwing for fixing sustentaculum tali of calcaneus.

METHODS

From May 2012 to October 2013, totally 50 patients (60 feet) with calcaneal fractures were analyzed, and divided into director for sustentaculum calcaneous tali screwing treatment group (group A) and ordinary screwing group(group B). In group A, there were 25 patients, including 22 males and 3 females, aged from 17 to 75 years old with an average of (45.08±11.98) years; according to Sanders classification, 9 feet were type II, 16 feet were type III, and 7 feet were type IV. In group B, there were 25 patients, including 20 males and 5 females, aged from 19 to 78 years old with an average of (46.36±15.74) years; according to Sanders classification, 8 feet were type II, 13 feet were type III, and 7 feet were type IV. Radiological change, operative time, postoperative complications were observed and compared, Maryland scoring at 1 year after operation was applied to evaluate clinical outcomes.

RESULTS

Fifty patients were followed up, group A was followed up from 12 to 24 months with an average of (17.72±4.08) months;while group B was followed up from 12 to 24 months with an average of (18.68±3.40) months;there was no significant difference between two groups in following-up time(>0.05). There were significant difference in operative time, complications and fluoroscopy times between two groups(<0.05). There were significant difference in Böhler angle and Gissanes angle between two groups before and after operation(<0.05). Maryland score at 1 year after operation in group A was (84.94±12.75) and (76.96±15.32) in group B, had significant meaning between two groups (<0.05).

CONCLUSIONS

Fixation of sustentaculum tali of calcaneus aided by director for sustentaculum tali screwing, has advantages of less operative time, fluoroscopy times, incidence of complications and good recovery of function, which could provide a new aiding method for treating intra-articular calcaneal fractures.

摘要

目的

探讨跟骨载距突导向器辅助跟骨载距突螺钉固定的临床疗效。

方法

分析2012年5月至2013年10月收治的50例（60足）跟骨骨折患者，分为跟骨载距突导向器辅助跟骨载距突螺钉固定治疗组（A组）和普通螺钉固定组（B组）。A组25例，男22例，女3例，年龄17～75岁，平均（45.08±11.98）岁；按Sanders分型，Ⅱ型9足，Ⅲ型16足，Ⅳ型7足。B组25例，男20例，女5例，年龄19～78岁，平均（46.36±15.74）岁；按Sanders分型，Ⅱ型8足，Ⅲ型13足，Ⅳ型7足。观察并比较两组的影像学改变、手术时间、术后并发症，采用术后1年的Maryland评分评价临床疗效。

结果

50例患者均获随访，A组随访12～24个月，平均（17.72±4.08）个月；B组随访12～24个月，平均（18.68±3.40）个月；两组随访时间差异无统计学意义（>0.05）。两组手术时间、并发症及透视次数差异有统计学意义（<0.05）。两组术前、术后Böhler角和Gissanes角差异有统计学意义（<0.05）。A组术后1年Maryland评分为（84.94±12.75）分，B组为（76.96±15.32）分，两组差异有统计学意义（<0.05）。