经皮撬拨复位克氏针内固定术或经跗骨窦小切口有限切开复位微型钢板内固定术联合硫酸钙植骨术治疗跟骨骨折的效果分析

Treatment effect of calcaneus fracture with percutaneous reduction and Kirschner wire internal fixation combined with calcium sulfate bone grafting and small incision and reduction of the sacral sinus combined with calcium sulfate bone grafting

目的探讨经皮撬拨复位克氏针内固定术或经跗骨窦小切口有限切开复位微型钢板内固定术联合硫酸钙植骨术治疗跟骨SandersⅡ、Ⅲ型、Ⅳ型骨折的效果。方法经皮撬拨复位克氏针内固定术联合硫酸钙植骨术(A组)与经跗骨窦小切口有限切开复位微型钢板内固定联合硫酸钙植骨术(B组)治疗跟骨SandersⅡ、Ⅲ型、Ⅳ型骨折患者,术后采用Ankle-Hindfoot scale系统评估相关肢体的功能,同时术后、术后3个月行影像学评估,测量Bohler角、Gissane角,并观察骨质愈合的情况。结果两组手术患者术后肢体功能均恢复较好,但两组之间术后相关肢体功能各项评分及总分比较差异均无统计学意义(P>0.05)。与B组相比,A组术后及术后3个月Bohler角较高,差异有统计学意义(P<0.05),Gissane角差异无统计学意义(P>0.05)。结论经皮撬拨复位克氏针内固定术或经跗骨窦小切口有限切开复位微型钢板内固定术联合硫酸钙植骨术治疗跟骨SandersⅡ、Ⅲ型、Ⅳ型骨折均具有良好的治疗效果。

Objective To investigate the treatment effect of calcaneus fracture Sanders Ⅱ ,Ⅲ and Ⅳ with percutaneous reduction and Kirschner wire internal fixation combined with calcium sulfate bone grafting and small incision and reduction of the sacral sinus combined with calcium sulfate bone grafting. Methods Percutaneous reduction and Kirschner wire internal fixation combined with calcium sulfate bone grafting （group A） and small incision and reduction of the sacral sinus combined with calei um sulfate bone grafting （group B） treatment of caleaneus patients with Sanders type Ⅱ ,Ⅲ and Ⅳ fractures were evaluated with the Ankle Hindfoot scale system for postoperative limb function. After surgery and three months after surgery, imaging e valuation was performed, Bohler angle, Gissane angle, and bone healing were observed. Results The limb function of the two groups recovered well after surgery, but the difference of postoperative related limb function scores and total scores between the two groups was not statistically significant （P〉0.05）. Compared with group B, Bohler angle was higher in group A after sur gery and three months after surgery, the difference was statistically significant （P〈0.05）, and there was no significant differ ence in Gissane angle （P〉0.05）. Conclusion Percutaneous reduction and Kirschner wire internal fixation combined with calcium sulfate bone grafting and small incision and reduction of the sacral sinus combined with calcium sulfate bone grafting have a good therapeutic effect for the treatment of calcaneus fracture Sanders Ⅱ ,Ⅲ and Ⅳ fractures.