急诊行跗骨窦小切口空心螺钉固定治疗跟骨骨折

Emergency surgery of calcaneal fractures with small tarsal sinus incision and cannulated screws fixation

目的 探讨急诊行跗骨窦小切口空心螺钉固定治疗跟骨骨折的疗效。方法 对19例跟骨骨折患者采用跗骨窦小切口空心螺钉内固定急诊手术。记录跟骨B9hler角及Gissane角、术后并发症发生情况、骨折愈合时间、踝关节活动度,采用AOFAS踝-后足评分评价疗效。结果 患者均获得随访,时间10~20(13.95±1.85)个月。切口均一期愈合,未发生切口裂开、感染、皮缘坏死、螺钉松动及畸形愈合等并发症。骨折愈合时间10~20(12.21±1.54)周。B9hler角及Gissane角术后、末次随访均较术前明显增加(P<0.05)。末次随访时,踝关节背伸20°~26°、跖屈35°~43°;采用AOFAS踝-后足评分评价疗效:总分72~97(89.47±5.65)分,优11例,良7例,可1例,优良率18/19。结论 急诊行跗骨窦小切口结合空心螺钉内固定治疗跟骨骨折切口小,并发症少,可获得满意的临床疗效。

Objective To investigate the effect of emergency surgery of calcaneal fractures with small tarsal sinus incision and cannulated screws internal fixation.Methods The 19 cases of calcaneal fractures were treated by the emergency operation with small tarsal sinus incision and cannulated screws internal fixation.B hler angle and Gissane angle of calcaneus were measured,postoperative complications and the range of ankle motion were recorded.AOFAS ankle-hindfoot function score was used to evaluate the effect.Results All cases were followed up for 10~20(13.95±1.85)months.All the incisions healed in the one-stage,while no complications such as incision dehiscence,incision infection,skin margin necrosis,screw loosening and malunion occurred.The fractures healed within 10~20(12.21±1.54)weeks,B hler angle and Gissane angle at the postoperation and last follow-up were significantly improved,compared with the preoperation(P<0.05).At the last follow-up,ankle dorsiflexion was 20°~26°and plantarflexion was 35°~43°;the curative effect assessed with AOFAS ankle-hindfoot function score:the total scores were 72~97(89.47±5.65)points,the result was excellent in 11 cases,good in 7,fair in 1,the excellent-good rate was 18/19.Conclusions Emergency operation of fractures with small tarsal sinus incision and cannulated screws internal fixation has smaller incision and few complications,while satisfactory clinical effect is obtained.