双螺杆撑开器辅助开放复位治疗SandersⅡ、Ⅲ型跟骨骨折
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柳州市工人医院

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广西科技计划项目 项目名称:区域性创伤急救体系的创新与应用示范


Application of Dual Screw Distractor in Operation Treatment for Sanders Type Ⅱ ,Ⅲ calcaneal Fractures
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柳州市工人医院/广西医科大学第四附属医院

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    摘要:

    [目的] 探讨应用双螺杆骨折撑开器辅助切开复位锁定钢板内固定治疗跟骨SandersⅡ、Ⅲ型骨折的操作方法和疗效分析。[方法]2016年2月~2017年5月期间,本院收治的14例(14足)粉碎性跟骨骨折患者,采用跟骨外侧L型切口, 术中使用内外侧双螺杆骨折撑开器辅助复位,置入跟骨锁定钢板固定。术后复查X线片及CT扫描。测量术前、术后和末次随访时Bohler角及Gissan角并采用美国足踝外科学会(American orthopaedic foot and ankle society,AOFAS)踝-后足功能评分。[结果]14例患者术后均获得随访。术后Bohle角和Gissan角测量数值比较,有统计学意义,末次随访时AOFAS踝-后足评分,优良率为92.8%(13/14)。2例患者术后出现切口愈合不良,1例患者术后出现了切口少量渗出,换药处理后创面愈合。所有骨折末次随访时均已愈合,至末次随访时未无感染、腓肠神经损伤、内固定松动情况发生。 [结论] 治疗跟骨SandersⅡ、Ⅲ型骨折,使用双螺杆撑开器辅助复位,可以有效恢复跟骨高度,避免骨折复位再丢失,简化操作,减少手术并发症,手术疗效好,学习曲线短,可推广性强。

    Abstract:

    Abstract: [objective] to investigate the application of dual screw distractor in operation treatment for Sanders type Ⅱ ,Ⅲ calcaneal fractures analysis of the operation method and curative effect.[methods] from February 2016 to May 2017, 14 patients (14 feet) with comminuted calcaneal fractures admitted in liuzhou workers' hospital, All patients were treated with the traditional l-shaped incision on the lateral calcaneal side, and the internal and external double-screw fracture brace was used to assist the reduction after the fracture end was raised and lowered. After the satisfactory fluoroscopy and reduction, the kirschner's needle was temporarily fixed, and the calcaneal locking plate was put in for solid fixation.Postoperative routine prevention of infection, close observation of incision complications, postoperative review of X-ray and CT scan.Bohler Angle and Gissan Angle at preoperative, postoperative and final follow-up were measured using the American orthopaedic foot and ankle society (AOFAS) ankle-hind foot function score.[results] all the 14 patients were followed up.At the last follow-up visit, the AOFAS ankle-hind foot score was 61 ~ 96, and 92.8% excellent rate (13/14).The wound healing was not good in 2 patients after surgery, and a small amount of incision exudation occurred in 1 patient after surgery. The bacterial culture was negative, and wound healing was strengthened after local drug replacement.All fractures healed at the last follow-up, and no infection, peroneal nerve injury, or internal fixation loosening occurred at the last follow-up.. [conclusion] treatment of calcaneal SandersSanders Ⅱ, Ⅲ type fractures, using application of dual screw distractor, can effectively restore the heel height, avoid the fracture again lost, simplify operation, reduce the surgical complications, surgical curative effect is good, short learning curve, can be powerful generalization

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  • 收稿日期:2019-06-13
  • 最后修改日期:2019-08-15
  • 录用日期:2019-08-23
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