撬拨与切开复位治疗SandersⅡ～Ⅳ型跟骨骨折的临床分析

Clinical Study on Sanders Ⅱ-Ⅳ Type of Calcaneus Fractures with Prying or Open Reduction

目的探讨经皮闭合撬拨穿针固定与切开复位内固定两种方式治疗SandersⅡ～Ⅳ型跟骨骨折的方法与效果。方法总结在我科治疗的上述病例,闭合克氏针撬拨复位固定33足;手术切开复位内固定26足。评价方式:对比手术前后Bhler角、Gissane角、Perie角、跟骨高度和宽度(与健侧对比)变化。结果平均随访18个月,两种方法术后效果明显,随访效果稳定。手术前后差异有统计学意义(P<0.05)。术后并发切口皮缘表浅坏死3足,针道感染1足,腓骨肌腱鞘炎1足。结论经皮闭合撬拨穿针固定与切开复位内固定均疗效满意,克氏针固定操作简便、创伤小且经济。

Objective The two different methods and effects are investigated,that between in treating Sanders Ⅱ-Ⅳ type of calcaneus fractures by percutaneous closure prying and pinning fixation or open reduction and internal fixation.Methods These cases treated in our department were summarized：33 feet with calcaneus fracture treated by percutaneous closure prying and pinning fixation,and 26 feet treated by open reduction and internal fixation.Evaluation methods：Contrast those index′s changes before and after surgery,such as：Bhler Angle,Gissane′s Angle,Perie Angle,and calcaneus height and width（contrast health side）.Results The average follow-up period 18 months,two kinds of methods obtained significant and stable effect at the end of postoperative follow-up.A significant postoperative difference appeared compared to preoperation（P0.05）.The postoperative complications：3 feet of skin incision margin shallow necrosis,1 foot of pin infections,1 foot fibular tenosynoitis.Conclusion Two methods of percutaneous closure prying and pinning fixation and open reduction and internal fixation lead to satisfied result,and Kirschner wire fixation are simple,minimally trauma and low cost.