| 分期手术应用带抗生素的人工骨植骨治疗开放性跟骨骨折 |
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投稿时间：2013-11-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 曾林如 |
ZENG Lin-ru |
杭州市萧山区中医院足踝外科中心, 浙江 杭州 311201 |
Ankle Surgery Center of Xiaoshan Traditional Chinese Medical Hospital of Hangzhou City, Hangzhou 311210, Zhejiang, Chinese |
zlr0303@126.com |
| 汤样华 |
TANG Yang-hua |
杭州市萧山区中医院足踝外科中心, 浙江 杭州 311201 |
Ankle Surgery Center of Xiaoshan Traditional Chinese Medical Hospital of Hangzhou City, Hangzhou 311210, Zhejiang, Chinese |
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| 徐灿达 |
XU Can-da |
杭州市萧山区中医院足踝外科中心, 浙江 杭州 311201 |
Ankle Surgery Center of Xiaoshan Traditional Chinese Medical Hospital of Hangzhou City, Hangzhou 311210, Zhejiang, Chinese |
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| 岳振双 |
YUE Zhen-shuang |
杭州市萧山区中医院足踝外科中心, 浙江 杭州 311201 |
Ankle Surgery Center of Xiaoshan Traditional Chinese Medical Hospital of Hangzhou City, Hangzhou 311210, Zhejiang, Chinese |
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| 张治金 |
ZHANG Zhi-jin |
杭州市萧山区中医院足踝外科中心, 浙江 杭州 311201 |
Ankle Surgery Center of Xiaoshan Traditional Chinese Medical Hospital of Hangzhou City, Hangzhou 311210, Zhejiang, Chinese |
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| 期刊信息：《中国骨伤》2014年，第27卷，第7期，第540-544页 |
| DOI：10.3969/j.issn.1003-0034.2014.07.003 |
| 基金项目: |
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中文摘要:
目的：探讨分期手术及应用负载万古霉素的人工骨植骨治疗开放性跟骨骨折的疗效。
方法：2006年1月至2012年12月收治13例开放性跟骨骨折患者，男9例，女4例；年龄23～66岁，平均35.2岁；均为急诊入院患者。跟骨骨折Sanders分型：Ⅱ型2例，Ⅲ型7例，Ⅳ型4例。软组织损伤Gustilo-Anderson分型：Ⅱ型8例，ⅢA型2例，ⅢB型2例，ⅢC型1例。Ⅰ期清创缝合或VSD术、延期行跟骨骨折切开复位钢板内固定加含抗生素人工骨植骨术。术后根据临床检查、影像学评估、美国足踝外科学会（AOFAS）踝-后足功能评分进行疗效评估。
结果：患者开放性伤口经创口换药修复等方法均顺利愈合，跟骨外侧切口Ⅰ期愈合。术后随访6～36个月，平均14.5个月；骨折愈合时间14～20周，平均16.2周。末次随访时AOFAS踝-后足功能评分为（80.0±7.4）（55～95分）.
结论：对于开放性跟骨骨折，通过合理临床评估，分期手术，应用带抗生素的人工骨植骨能够降低术后的创口感染发生率以及促进骨折愈合。 |
| 【关键词】跟骨 骨折 骨移植 骨折固定术，内 |
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| Surgical staging applications with antibiotic graft bone for the treatment of open calcaneal fractures |
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ABSTRACT
Objective: To discuss the effect of surgical staging and using craft bone with vancomycin for the treatment of calcaneal fractures.
Methods: From January 2006 to December 2012,13 patients with open calcaneal fractures were treated including 9 males and 4 females with an average of 35.2 years old ranging from 23 to 66. All cases were emergency cases. According to Sanders classification of calcaneal fractures,2 cases were type Ⅱ,7 cases were type Ⅲ,4 cases were type Ⅳ. According to Gustilo-Anderson soft tissue injury classification,8 cases were type Ⅱ,2 cases were type ⅢA,2 cases were type ⅢB,1 case were type Ⅲ C. Firstly a thorough debridement or VSD procedures were applied,secondly calcaneal fracture were treated with open reduction,plate fixation and bone graft complex with antibiotics. Based on clinical examination,radiographic evaluation,and American Foot and Ankle Surgery Society(AOFAS),ankle function were evaluated after operation.
Results: Open wounds were headed after dressing and repairing,lateral calcaneal wound were healed during the first period. All patients were followed up for 6 to 36 months (means 14.5 months). Fracture healing time was 14 to 20 weeks (means 16.2 weeks). Last follow-up AOFAS ankle-hindfoot score was (80.0±7.4) ranging from 55 to 95.
Conclusion: For patients with open fractures,through reasonable clinical evaluation,staging operation,using bone graft with antibiotics can reduce the incidence of postoperative wound infection and promote fracture healing. |
| KEY WORDS Calcaneus Fractures Bone transplantation Fracture fixation,internal |
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| 中文格式: | 曾林如,汤样华,徐灿达,岳振双,张治金.分期手术应用带抗生素的人工骨植骨治疗开放性跟骨骨折[J].中国骨伤,2014,27(7):540~544 |
| 英文格式: | ZENG Lin-ru,TANG Yang-hua,XU Can-da,YUE Zhen-shuang,ZHANG Zhi-jin.Surgical staging applications with antibiotic graft bone for the treatment of open calcaneal fractures[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(7):540~544 |
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