撬拨复位力臂式支架联合横向镙钉治疗SandersⅢ,Ⅳ型跟骨骨折的临床研究

Clinical Research on Poking Reduction Arm Stents Combined with Horizontal Screws in the Treatment of Calcaneal Fractures of Sanders Type Ⅲ and Ⅳ

目的:探讨撬拨复位力臂式支架联合横向镙钉固定治疗Sanders Ⅲ,Ⅳ型跟骨骨折的疗效,为其推广应用提供理论依据。方法:选取70例Sanders Ⅲ,Ⅳ型跟骨骨折患者进行分组,治疗组与对照组各35例;治疗组治疗方法为撬拨复位力臂式支架联合横向镙钉固定;对照组治疗方法为切开复位钢板内固定。记录每例患者的手术时间、术中出血量、术后X线片指标Bohler角及横径恢复情况,并发症发生率及术后12个月随访按Kerr评分标准评定患者的临床疗效。结果:所有病例均获得12~18个月随访,两组病例在手术时间、术中出血量、术后X线片Bohler角及横径恢复指标方面,差异有统计学意义(P<0.05),并发症发生率及Kerr疗效评分差异无统计学意义(P>0.05)。结论:撬拨复位力臂式支架联合横向镙钉固定治疗操作便捷、损伤小、疗效可靠,值得推广应用。

Objectives： To explore the efficacy of poking reduction arm stents combined with horizontal screws in the treatment of calcaneal fractures of Sanders type Ⅲ and Ⅳ, and to provide theoretical basis for its application. Methods： All 70 cases of calcaneal fractures of Sanders type Ⅲ and Ⅳ were selected, 35 cases in the treatment group and 35 cases in the control group; the treatment group were treated with poking reduction arm stents combined with horizontal screws fixation, and the control group were treated with open reduction and plate internal fixation. The operation time, the intraoperative blood loss and the recovery situation of postoperative X-ray index of Bohler angle and transverse diameter were recorded for each patient. The clinical efficacy of the patients was assessed by the incidence of complications and the 12 months postoperative follow-up according to the Kerr＇s score criteria. Results： All cases were followed up for 12 to 18 months. There were significant differences between the two groups in the operation time, intraoperative blood loss, postoperative X-ray of Bohler angle and transverse diameter recovery index（P〈0.05）, but there was no significant difference in the incidence of complications and Kerr＇s score criteria（P〉0.05）. Conclusion： Poking reduction arm stents combined with horizontal screws fixation has an advantage of convenient operation, tinier injured and reliable efficacy, which is worthy for popularization and application.