合并胸腰椎骨折的双侧跟骨骨折手术疗效分析

Analysis of the Curative Effect of Surgical Treatment of Double Calcaneal Fractures in Patients with Thoracolumbar Fractures

目的对外侧L形切口切开复位内固定治疗合并胸腰椎骨折的双侧闭合性跟骨骨折的疗效进行评价。方法毕节市第一人民医院对2015年1月-2018年6月符合纳入标准的28例二期行外侧L形切口手术治疗合并胸腰椎骨折的双侧闭合性跟骨骨折患者进行回顾性研究。其中SanderⅡ型18足,Ⅲ型24足,Ⅳ型14足,对其手术前、术后3、6、12月Bohler和Gissane角,切口愈合情况,依照AOFAS标准评价末次随访足部功能等指标进行分析。结果术后跟骨切口均甲级愈合,平均随访时间13个月,均达骨性愈合。手术前和术后3、6、12月Bohler和Gissane角对比有显著性差异(P<0.05),术后3、6、12月Bohler和Gissane角对比无显著差异(P>0.05)。结论先行胸腰椎骨折椎弓根钉内固定,二期外侧L切口切开复位内固定治疗合并胸腰椎骨折的双侧闭合性SanderⅡ-Ⅳ型跟骨骨折是一种安全、有效的方法。

Objective To evaluate efficacy of surgical treatment of double calcaneal fractures in thoracolumbar fractures patients.Methods A retrospective study which 28 patients whose were been Surgical Treatment by the L shaped lateral incision of the double calcaneal fractures in patients with thoracolumbar fractures were conducted from Jan 2015 to June 2018.It includ SandersⅡ18 cases,Ⅲ24 cases,Ⅳ14 cases,observed the value changes of Bohler angle and Gissane angle of Preoperative,3,6 and 12 months after operation.Postoperative incision complication,used AOFAS standard for evaluation of foot function after surgery.Results All wounds were healed after operation.All patients were followed up for 13 months in average,all fractures union.Bohler and Gissane angles of the calcaneus have been significant improvement in the after operation whice compared Preoperative(P<0.05).There was no significant difference in the 3,6 and 12 months after operation of Bohler and Gissane angles.Conclusion First phase pedicle screw fixation and second-stage open reduction and internal fixation throμgh L-incision is a safe and effective method to treat patients of bilateral closed SanderⅡ-Ⅳcalcaneal fractures who accompanied by thoracolumbar fractures.