经皮撬拨复位植骨联合有限内固定治疗跟骨骨折

[Percutaneous poking reduction with bone grafting and limited internal fixation for the treatment of calcaneal fractures].

作者信息

Chen Hua, Li Yu-Wei, Jiang Hong, Zhang Zhi-Gang, Lu Bin-Jie

机构信息

Department of Orthopaedics, Suzhou Hospital of TCM Affiliated Nanjing University of Chinese Medicine, Suzhou 215009, Jiangsu, China.

Department of Orthopaedics, Suzhou Hospital of TCM Affiliated Nanjing University of Chinese Medicine, Suzhou 215009, Jiangsu, China;

出版信息

Zhongguo Gu Shang. 2017 Dec 25;30(12):1084-1090. doi: 10.3969/j.issn.1003-0034.2017.12.003.

DOI:10.3969/j.issn.1003-0034.2017.12.003

PMID:29457428

Abstract

OBJECTIVE

To investigate clinical effects of percutaneous poking reduction with bone grafting and limited internal fixation for the treatment of calcaneal fractures.

METHODS

From May 2013 to October 2016, 53 patients with closed calcaneal fractures were analyzed, and were divided into treatment group and control group. There were 33 patients in treatment group including 25 males and 8 females, aged from 15 to 82 years old with an average of(44.7±14.2) years old; 17 cases were type II and 16 cases were type III according to Sanders classification; treated by percutaneous poking reduction with bone grafting and limited internal fixation. There were 33 patients in control group, including 20 males aged from 25 to 62 years old with an average of (42.2±11.3) years old; 8 cases were type II and 12 cases were type III according to Sanders classification; treated by open reduction and internal fixation. Imaging indicators, hospital stays and preoperative waiting time were observed and compared, Maryland scoring were applied to evaluate foot function.

RESULTS

Fifty-three patients were followed up, and treatment group was followed up from 8 to 40 months with an average of (19.9±7.2) months; while control group was followed up from 12 to 40 months with an average of (21.7±7.7) months, and there were not significant differences between two groups in follow-up time (>0.05). There were no obvious meaning in Böhler angles, Gissane angles between two groups (>0.05). There were significant differences in hospital stays and preoperative waiting time(<0.01). There were no significant differences in Maryland score between treatment group(90.45±5.76) and control group(89.10±6.16).

CONCLUSIONS

Percutaneous poking reduction with bone grafting and limited internal fixation for the treatment of calcaneal fractures could obtain satisfied effects, and has advantages of less trauma and complications, rapid recovery and good clinical effects.

摘要

目的

探讨经皮撬拨复位植骨有限内固定治疗跟骨骨折的临床效果。

方法

分析2013年5月至2016年10月收治的53例闭合性跟骨骨折患者，分为治疗组和对照组。治疗组33例，男25例，女8例，年龄15～82岁，平均（44.7±14.2）岁；Sanders分类Ⅱ型17例，Ⅲ型16例；采用经皮撬拨复位植骨有限内固定治疗。对照组33例，男20例，年龄25～62岁，平均（42.2±11.3）岁；Sanders分类Ⅱ型8例，Ⅲ型12例；采用切开复位内固定治疗。观察比较两组影像学指标、住院时间及术前等待时间，应用Maryland评分评价足部功能。

结果

53例患者均获随访，治疗组随访8～40个月，平均（19.9±7.2）个月；对照组随访12～40个月，平均（21.7±7.7）个月，两组随访时间比较差异无统计学意义（>0.05）。两组Böhler角、Gissane角比较差异无统计学意义（>0.05）。两组住院时间及术前等待时间比较差异有统计学意义（<0.01）。治疗组Maryland评分（90.45±5.76）与对照组（89.10±6.16）比较差异无统计学意义。