手法整复硬纸夹板外固定治疗跟骨骨折60例

Manipulative reduction and external fixation with cardboard splint for the treatment of calcaneal fractures:a 60-case report

目的:探讨跟骨骨折手法复位的治疗效果。方法:2009年1月至2012年6月治疗SandersⅠ-Ⅳ型跟骨骨折患者53例(60足);男45例,女8例;年龄18~65岁,平均(33.5±1.54)岁;病程0.5 h^7 d。采用手法复位,并以硬纸夹板外固定。治疗前患足肿痛、活动受限明显,部分患足外观宽扁畸形,影像学检查见跟骨骨皮质连续性中断。治疗后采用Creighton-Nebraska跟骨骨折评价标准进行疗效评价。结果:所有患者治疗后12个月随访,按照Creighton-Nebraska跟骨骨折评价标准评定疗效结果,优13足,良34足,可11足,差2足。结论:SandersⅠ-Ⅳ型跟骨骨折手法治疗临床疗效佳,手法复位既简便又经济,可最大限度恢复跟骨功能,减少并发症,利于足踝功能尽早康复。

Objective:To investigate the therapeutic effects of manipulative reduction for calcaneal fractures. Methods:From January 2009 to June 2012,53 cases(60 affected feet) of Sanders typeⅠ-Ⅳ calcaneal fractures were treated by manipulative reduction and external fixation with cardboard splint,including 45 males and 8 females with an average age of(33.5±1.54) years old ranging from 18 to 65. The course of disease ranged 0.5 h to 7 d. Before treatment the feet were swelling,ache and activity limitation in evidence,some feet were wide flat deformity,the cortical bone was broken in the imaging examination.All selected cases were evaluated using Creighton-Nebraska health foundation assessment scale for fractures of calcaneus. Results:All cases were followed up at 12 months after treatment,13 feet got excellent curative effect,34 good,11 moderate and 2poor. Conclusion:Manipulative reduction for Sanders typeⅠ-Ⅳ calcaneal fractures could get excellent curative effect. Manipulative reduction for calcaneal fractures could avoid surgical trauma while assure high curative effects. Manipulative reduction is not only economical and easy therapy,but also can restore maximum function of the calcaneus with few complications and facilitate early rehabilitation of ankle and joint function.