探讨跟骨钉中钉手术较传统手术方式治疗跟骨骨折的优势.回顾性收集自2021年4月—2024年4月间跟骨骨折Sanders分型Ⅱ-Ⅲ型46例患者临床资料,根据治疗方式不同随机分为微创组(采用跟骨钉中钉内固定系统微创治疗,23例)和传统组(传统切开复...探讨跟骨钉中钉手术较传统手术方式治疗跟骨骨折的优势.回顾性收集自2021年4月—2024年4月间跟骨骨折Sanders分型Ⅱ-Ⅲ型46例患者临床资料,根据治疗方式不同随机分为微创组(采用跟骨钉中钉内固定系统微创治疗,23例)和传统组(传统切开复位内固定治疗,23例),记录两组术前待术时间、手术时间、术后住院时间、术中出血量、手术并发症、术后1周、1月及1年功能恢复等情况,并进行比较,采用SPSS 23.0软件进行统计学分析,并于末次随访时按照Maryland足部评分系统评分.微创组与传统组患者在平均手术时间(78min vs 105min)、术中出血量(9.5ml vs 55ml)、Maryland足功能评分系统判定术后1周、术后1月及1年优良率(分别73.91%vs 43.48%,91.3%vs 78.2%,100%vs 91.3%)间差异均具有统计学意义(P<0.01).钉中钉内固定系统在跟骨骨折较以往传统切开复位内固定手术有明显优势,可缩短住院时间,术后功能恢复亦较良好,值得推广应用.展开更多
Objective： To explore the safety and effect of the technique of reconstructing anterior and middle columns by posterior approach in treating lumbar burst fractures. Methods： From July 2005 to January 2007, 22 cases ...Objective： To explore the safety and effect of the technique of reconstructing anterior and middle columns by posterior approach in treating lumbar burst fractures. Methods： From July 2005 to January 2007, 22 cases （18 males and 4 females, aged 28-57 years, 42.7 years on average） of lumbar burst fractures were treated with surgical procedures in our hospital. Based on the routine posterior approach, one of the transverse processes of the injured vertebra was incised to get access to the lateral side of the injured vetebral body. After all the displaced fracture fragments were cleared away and the spinal canal was decompressed, the titanium mesh packed with autografts was implanted from the lateral side to reconstruct the anterior and middle columns. The adjacent above and below segments of the vetebral body were fixed with transpedicular screws. The operation time, intraoperative blood loss, vertebral height, degree of kyphotic deformity and comprised spinal canal were documented. Results： The average operation time was 3.5 hours （ranging 2.8-5.8 hours） and the average blood loss was 820 ml （ranging 650-2 100 ml）. All the cases were followed up for 17.2 months on average （ ranging 12-28 months）. The height of the injured vetebral body was restored from 24 % （12%- 45%） preoperatively to 96% （95%-99%） postoperatively （P〈0.05）. The natural spinal curvatures and spinal canal were restored. Three cases were involved in transient iatrogenic nerve root injury and 1 case was involved in the loosening of the connected rod of the pedicle screw system 3 months postoperatively. Conclusions： The technique of implanting the titanium mesh by posterior approach is effective and safe enough to reconstruct the anterior and middle columns in treating lumbar burst fractures.展开更多
文摘探讨跟骨钉中钉手术较传统手术方式治疗跟骨骨折的优势.回顾性收集自2021年4月—2024年4月间跟骨骨折Sanders分型Ⅱ-Ⅲ型46例患者临床资料,根据治疗方式不同随机分为微创组(采用跟骨钉中钉内固定系统微创治疗,23例)和传统组(传统切开复位内固定治疗,23例),记录两组术前待术时间、手术时间、术后住院时间、术中出血量、手术并发症、术后1周、1月及1年功能恢复等情况,并进行比较,采用SPSS 23.0软件进行统计学分析,并于末次随访时按照Maryland足部评分系统评分.微创组与传统组患者在平均手术时间(78min vs 105min)、术中出血量(9.5ml vs 55ml)、Maryland足功能评分系统判定术后1周、术后1月及1年优良率(分别73.91%vs 43.48%,91.3%vs 78.2%,100%vs 91.3%)间差异均具有统计学意义(P<0.01).钉中钉内固定系统在跟骨骨折较以往传统切开复位内固定手术有明显优势,可缩短住院时间,术后功能恢复亦较良好,值得推广应用.
文摘Objective： To explore the safety and effect of the technique of reconstructing anterior and middle columns by posterior approach in treating lumbar burst fractures. Methods： From July 2005 to January 2007, 22 cases （18 males and 4 females, aged 28-57 years, 42.7 years on average） of lumbar burst fractures were treated with surgical procedures in our hospital. Based on the routine posterior approach, one of the transverse processes of the injured vertebra was incised to get access to the lateral side of the injured vetebral body. After all the displaced fracture fragments were cleared away and the spinal canal was decompressed, the titanium mesh packed with autografts was implanted from the lateral side to reconstruct the anterior and middle columns. The adjacent above and below segments of the vetebral body were fixed with transpedicular screws. The operation time, intraoperative blood loss, vertebral height, degree of kyphotic deformity and comprised spinal canal were documented. Results： The average operation time was 3.5 hours （ranging 2.8-5.8 hours） and the average blood loss was 820 ml （ranging 650-2 100 ml）. All the cases were followed up for 17.2 months on average （ ranging 12-28 months）. The height of the injured vetebral body was restored from 24 % （12%- 45%） preoperatively to 96% （95%-99%） postoperatively （P〈0.05）. The natural spinal curvatures and spinal canal were restored. Three cases were involved in transient iatrogenic nerve root injury and 1 case was involved in the loosening of the connected rod of the pedicle screw system 3 months postoperatively. Conclusions： The technique of implanting the titanium mesh by posterior approach is effective and safe enough to reconstruct the anterior and middle columns in treating lumbar burst fractures.
