微创空心螺钉内固定与钢板内固定治疗跟骨骨折的临床观察

Study on Efficacy of Small Incisions Surgery with Kirschner Wire and Incision on Intra-articular Fracture of the Intra Articular Calcaneal Fractures

目的:比较经皮微创空心螺钉内固定与钢板复位内固定治疗跟骨骨折的疗效。方法:收集48例(59足)跟骨骨折的临床资料,分为两组,A组:经皮微创空心螺钉内固定治疗32足(Ⅱ型16足、Ⅲ型10足、Ⅳ型6足);B组:钢板复位内固定治疗27足(Ⅱ型14足、Ⅲ型8足、Ⅳ型5足)。观察两种方法治疗前后患足功能的恢复情况,评定治疗的优良率。结果:经6个月至2年随访,患者均获得骨性愈合。两种方法治疗后Bohler角、Gissane角、优良率比较差异均无统计学意义(P>0.05)。钢板复位内固定组发生1例腓骨长肌腱鞘炎。结论:微创空心螺钉内固定治疗SandersⅡ、Ⅲ型跟骨骨折手术时间短、软组织并发症少,是一种理想的手术方法;对于SandersⅣ型跟骨骨折应在直视下行复位植骨钢板内固定术。

Objective： To evaluate the efficacy of the small incisions Surgery with Kirschner wire and incision in the treatment of intra articular calcaneal fractures. Method ：48 patients with caleaneal fractures were divided into groups A（ 32 cases, small incisions Surgery with Kirschner wire ）and B（ 27 cases, lateral incision ） . Statistical analysis were conducted to compare the incision healing time, complication rate, operation time, AO FAS score, Bohler angle, Gissane angle, intraoperative blood loss and the hospitalization charges were observed among the two groups. Result： There were no statistical differences detected among the groups in Bohler angle, Gissane angle and AO FAS score （ P〈O.05 ） .The operation time, intracperative blood loss, incision healing time in groups A were significantly less than that in the group B （ P〉0.05 ） . Conclusion： Two methods showed satisfactory functional recovery for intra-articular fracture of the calcaneas, small incisions Surgery with Kirschner wire is a usefuI method to treat the Sanders II, III bone fracture. Incision is a usefuI method to treat the Sanders IV bone fracture.