经皮微创撬拨复位空心钉内固定治疗跟骨骨折研究

Treatment of calcaneal fracture with percutaneous minimally invasive prying reduction and hollow nail internal fixation

目的观察经皮微创撬拨复位空心钉内固定治疗跟骨骨折的临床效果。方法选择2016年8月～2017年12月期间在本院接受治疗的跟骨骨折患者56例作为研究对象,随机划入观察组和对照组,各28例,分别接受经皮微创撬拨复位空心钉内固定和常规内固定术治疗,比较两组患者的术后跟骨B?hler角、Gissane角、Maryland踝足功能评分、手术时间、术中出血量、骨折愈合时间和并发症发生例数。结果观察组患者手术时间(92.8±6.4)min,术中出血量(96.5±15.2)ml,住院时间(18.7±2.4)d,骨折愈合时间(10.7±2.4)周;对照组患者手术时间(63.9±7.6)min,术中出血量(159.8±12.4)ml,住院时间(13.5±1.8)d,骨折愈合时间(12.6±1.3)周;组间比较差异有统计学意义(P<0.05)。观察组患者B?hler角(21.8±1.6)°,Gissane角(124.5±2.8)°,Maryland评分(92.4±2.6)分,并发症2例;对照组患者B?hler角(17.2±2.3)°,Gissane角(138.7±3.2)°,Maryland评分(72.5±3.8)分,并发症8例;组间差异有统计学意义(P<0.05)。结论经皮微创撬拨复位空心钉内固定治疗跟骨骨折临床效果显著,值得临床应用和推广。

Objective To observe the clinical effect of percutaneous minimally invasive prying reduction and hollow- nail fixation for calcaneal fracture. Methods 56 cases of calcaneal fracture treated in our hospital from August 2016 to December 2017 were randomly divided into observation group （n 28） and control group （n 28）. The patients were treated with percutaneous minimally invasive prying reduction and hollow- nail fixation and conventional internal fixation respectively. The functional score, operative time, intraoperative blood loss, fracture healing time and complica- tions of Bghler angle of calcaneus were compared between the two groups. The number of occurrences. Results The operative time, intraoperative bleeding volume, hospitalization time and fracture healing time were （92.8±6.4） min, （96.5±15.2） ml, （18.7±2.4） d, （10.7±2.4） weeks, （63.9±7.6） min, （159.8 ±12.4） ml, （13.5 ±1.8） d, （12.6 ±1.3） weeks, respectively. There was significant difference between the two groups （P〈0.05）. The Bohler angle of the patients in the observation group was （21.8±1.6）°. Gissaaae angle （124.5±2.80）° Maryland score （92.4 ±2.6） and Bhler angle （17.2±2.3）° Gissane angle （138.7±3.2）° Maryland score were （72.5 ±3.8）° in the control group in the control group, and there was significant difference between the two groups （P〈0.05）. Conclusion The treatment of calcaaaeal fracture with percutaneous minimally invasive prying reduction and hollow- nail is effective and worthy of clinical application and popularization.