闭合复位空心加压螺纹钉治疗跟骨骨折的疗效观察

Closed reduction and internal fixation with cannulated screw for the treatment of calcaneal fractures

目的研究微创方法闭合复位经皮斯氏针撬拨复位空心钉内固定治疗跟骨骨折。方法 2000年2月～2010年12月,C臂机透视下经皮斯氏针撬拨闭合复位空心钉内固定治疗SandersⅡ、Ⅲ、Ⅳ型跟骨骨折46例。结果术后经6～24个月（平均18个月）的随访,骨折愈合时间平均2.6个月,术后无感染及皮肤坏死、断钉等并发症。X线片显示Bohler角度平均为36.8°,Gissane角度126°~138°,根据美国足踝骨科协会的足踝临床评分系统标准评价：优36例,良6例,一般4例。优良率达到91.3%。结论应用经皮微创空心钉内固定治疗跟骨骨折操作简单、手术时间短、对软组织破坏小、骨折固定牢靠稳定,值得推广。

Objective To explore the effects of minimally invasive treatment of calcaneal fractures with cannulated screw. Methods From February 2000 to December 2010, 46 patients with calcaneal fractures （SandersⅡ, Ⅲ, Ⅳ） were treated with closed prying and internal fixation with cannulated screw under C-arm image intensification. Results All cases were followed up for 6-24 months （18 months on average） after the operation and the findings suggested that fracture healing time averaged 2.6 months. No serious adverse complications such as infected incision, skin necrosis, and broken screw were observed. X-ray films revealed Bo..hler＇s angle 36.8° and Gissane＇s 126°-138°. According to the clinical scoring system of the American Orthopaedic Foot and Ankle Society, 36 feet were excellent, 6 cases of good and 4 cases of fair. The satisfactory rate accounted for 91.3%. Conclusion Minimally invasive surgery with cannulated screw is a good option for calcaneal fractures with less injury, easy operation, shorter operation time,rapid recovery, less damages to soft tissue and stable fixation.