| 经跗骨窦小切口治疗SandersⅡ型跟骨关节内骨折 |
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投稿时间：2017-01-13
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| 作者 | Author | 单位 | Address | E-Mail |
| 包学迅 |
BAO Xue-xun |
宁波市鄞州区第二医院, 浙江 宁波 315040 |
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| 夏臣杰 |
XIA Chen-jie |
宁波市鄞州区骨伤科医院, 浙江 宁波 315101 |
Department of Orthopaedic and Traumatic Surgery, Yinzhou Traumatic and Orthopedic Hospital of Ningbo City, Ningbo 315101, Zhejiang, China |
xiachenjie1990@sina.com |
| 赵必允 |
ZHAO Bi-yun |
宁波市鄞州区骨伤科医院, 浙江 宁波 315101 |
Department of Orthopaedic and Traumatic Surgery, Yinzhou Traumatic and Orthopedic Hospital of Ningbo City, Ningbo 315101, Zhejiang, China |
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| 史德军 |
SHI De-jun |
宁波市鄞州区第二医院, 浙江 宁波 315040 |
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| 兰观华 |
LAN Guan-hua |
宁波市鄞州区第二医院, 浙江 宁波 315040 |
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| 任国林 |
REN Guo-lin |
宁波市鄞州区骨伤科医院, 浙江 宁波 315101 |
Department of Orthopaedic and Traumatic Surgery, Yinzhou Traumatic and Orthopedic Hospital of Ningbo City, Ningbo 315101, Zhejiang, China |
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| 谢祖宏 |
XIE Zu-hong |
宁波市鄞州区骨伤科医院, 浙江 宁波 315101 |
Department of Orthopaedic and Traumatic Surgery, Yinzhou Traumatic and Orthopedic Hospital of Ningbo City, Ningbo 315101, Zhejiang, China |
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| 杜文喜 |
DU Wen-xi |
浙江中医药大学附属第一医院, 浙江 杭州 310006 |
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| 期刊信息：《中国骨伤》2017年，第30卷，第8期，第755-758页 |
| DOI：10.3969/j.issn.1003-0034.2017.08.015 |
| 基金项目:浙江省中西医结合骨关节病研究科技创新团队项目（编号：2011R50022-07） |
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中文摘要:
目的：探索微创跗骨窦切口治疗SandersⅡ型跟骨关节内骨折的可行性及疗效。
方法：自2015年8月至2016年7月，采用跗骨窦小切口钢板螺钉内固定治疗13例SandersⅡ型跟骨骨折患者（共13足），其中男12例，女1例；年龄26~65岁，平均45岁。均为高处坠落伤。比较手术前后Böhler角（B角）、Gissane角（G角）以及跟骨长、宽、高的复位情况，术后参照美国矫形外科足踝协会提出AOFAS后踝和足评分系统进行疗效评价。
结果：术后13例患者获得随访，时间6~15个月，平均9.5个月，无一例发生切口并发症。Böhler角由术前的（18.82±5.11）°提高至术后的（26.63±4.45）°，两组比较差异有统计学意义（t=-4.16，P=0.000）；Gissane角由术前的（111.07±15.36）°提高至术后的（124.56±8.71）°，两组比较差异有统计学意义（t=-2.75，P=0.011）；跟骨的长、宽、高度术前分别为（69.82±5.95），（42.07±3.68），（41.20±3.90） mm，术后（72.61±5.46），（39.10±4.02），（44.03±3.33） mm，差异无统计学意义（P>0.05）。术后AOFAS总分为88.2±5.9，其中优8例，良4例，可1例。
结论：跗骨窦小切口治疗SandersⅡ型跟骨骨折创伤小，有效重建距下关节面，但应避免选择外侧壁严重粉碎，长、宽、高度及内外翻明显改变的患者。 |
| 【关键词】跟骨 关节内骨折 外科手术 |
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| Treatment of SandersⅡ calcaneus fractures via minimally invasive sinus tarsi approach |
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ABSTRACT
Objective: To study the feasibility and clinical efficacy of a minimally invasive sinus tarsi approach in the treatment of SandersⅡ calcaneus fractures.
Methods: From August of 2015 to July of 2016,13 patients(totally 13 feet) with SandersⅡ intra-articular calcaneus fractures were treated via the minimally invasive sinus tarsi approach. The Böhler angle,Gissane angle and the length,width and height of calcaneus were compared between pre-operation and post-operation. The AOFAS ankle and foot scoring system of the orthopaedic ankle foot Association was used to evaluate the efficacy.
Results: All the patients were followed up,and the duration ranged from 6 to 15 months,with an average of 9.5 months. No incision complications occurred. The Böhler angle was increased from preoperative (18.82±5.11)° to postoperative(26.63±4.45)°(t=-4.16,P=0.000). The Gissane angle was increased from preoperative(111.07±15.36)° to postoperative (124.56±8.71)° (t=-2.75,P=0.011). The length,width,height of calcaneus were absolutely improved from preoperative(69.82±5.95) mm,(42.07±3.68) mm,(41.20±3.90) mm to preoperatively(72.61±5.46) mm,(39.10±4.02) mm,(44.03±3.33) mm. According to the AOFAS,8 patients got an excellent result,4 good and 1 poor,and the postoperative mean score was 88.2±5.9.
Conclusion: The limited open sinus tarsi approach could be used successfully to treat displaced SandersⅡ fractures with less injury and effectively restored the surface of subtalar joint,however the method is not fit for the patients with comminuted fracture in lateral wall and great change in the length,width,height,varus and valgus of calcaneus. |
| KEY WORDS Calcaneus Intra-articular fractures Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 包学迅,夏臣杰,赵必允,史德军,兰观华,任国林,谢祖宏,杜文喜.经跗骨窦小切口治疗SandersⅡ型跟骨关节内骨折[J].中国骨伤,2017,30(8):755~758 |
| 英文格式: | BAO Xue-xun,XIA Chen-jie,ZHAO Bi-yun,SHI De-jun,LAN Guan-hua,REN Guo-lin,XIE Zu-hong,DU Wen-xi.Treatment of SandersⅡ calcaneus fractures via minimally invasive sinus tarsi approach[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(8):755~758 |
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