| 跟骨骨折经皮穿针小切口植骨与非植骨治疗的比较研究 |
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Received:July 28, 2008
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| 作者 | Author | 单位 | Unit | E-Mail |
| 聂伟志 |
NIE Wei-zhi |
文登整骨医院,山东 文登 264400 |
Wendeng Orthopaedic Hospital, Wendeng 264400,Shandong,China |
nieweizhi@163.com |
| 孙磊 |
SUN Lei |
文登整骨医院,山东 文登 264400 |
Wendeng Orthopaedic Hospital, Wendeng 264400,Shandong,China |
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| 杨茂清 |
YANG Mao-qing |
文登整骨医院,山东 文登 264400 |
Wendeng Orthopaedic Hospital, Wendeng 264400,Shandong,China |
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| 谭远超 |
TAN Yuan-chao |
文登整骨医院,山东 文登 264400 |
Wendeng Orthopaedic Hospital, Wendeng 264400,Shandong,China |
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| 朱惠芳 |
ZHU Hui-fang |
文登整骨医院,山东 文登 264400 |
Wendeng Orthopaedic Hospital, Wendeng 264400,Shandong,China |
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| 期刊信息：《中国骨伤》2009年22卷，第1期，第1-3页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目:“十五”国家科技攻关计划课题(编号：2004BA721A01Z68) |
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目的：报告PaleyⅡ型跟骨骨折的闭合复位经皮穿针内固定、小切口植骨的微创治疗方法，并与非植骨法进行比较。
方法：回顾2002年至2006年PaleyⅡ型跟骨骨折112例，植骨组56例，男36例，女20例；年龄21～65岁，平均(42.0±2.3)岁；Ⅱa型11例，Ⅱb型45例；坠落伤38例，车祸伤18例；伤后至手术时间3～14 d,平均(6.0±1.2) d.非植骨组56例，男38例，女18例；年龄22～67岁，平均(43.0±2.5)岁；Ⅱa型13例，Ⅱb型43例；坠落伤40例，车祸伤16例；伤后至手术时间2～15 d,平均(5.0±2.1) d.全部病例均采用闭合复位经皮穿针内固定，植骨组加用小切口植骨治疗，比较两组治疗后的骨折再度塌陷率及优良率。
结果：两组病例均得到随访，时间最短5个月，最长52个月，经统计分析，两组随访时间差异无统计学意义。植骨组无再度塌陷病例，非植骨组有3例再度塌陷。参照张铁良评分标准，植骨组优43例，良12例，可1例，差0例，优良率98.2%;非植骨组优37例，良16例，可2例，差1例，优良率94.7%.经Ridit分析，两组差异有统计学意义(P<0.05).
结论：闭合复位经皮穿针后加用小切口植骨能够防止跟骨后距关节面再度塌陷，促进骨折愈合，提高疗效，可以作为Paley II型跟骨骨折的标准治疗方案。 |
| [关键词]:跟骨骨折 骨折固定术,内 骨移植 回顾性研究 |
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| Comparison between mini-traumatic bone-grafting and non-bone-grafting in percutaneous K-wire fixation to treat the calcaneal fractures |
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Abstract:
Objective: To compare the effect between mini-traumatic bone-grafting and non-bone-grafting in percutaneous K-wire fixation for treating the calcaneal fractures.
Methods: From 2002 to 2006,112 patients with the type Ⅱ(Paley type) fractures of calcaneus were studied. There were 56 cases in bone-grafting group involving 36 males and 20 famales,aged from 21 to 65,averaged (42.0±2.3) years;11 cases were in type Ⅱa and 45 were in type Ⅱb;the course was from 3 to 14 days, averaged (6.0±1.2) days. And there were 56 cases in non-bone-grafting group involving 38 males and 18 famales,aged from 22 to 67,averaged (43.0±2.5)years;13 cases were in type Ⅱa and 43 were in typeⅡb;the course was from 2 to 15 days,averaged(5.0±2.1) days. All the cases were treated by closed reduction and percutaneous K-wire fixation,and bone-grafting group(56 cases)were treated by mini-traumatic bone-grafting,but the other group(56 cases)were not. The collapsing rate and fineness rate were compared.
Results: All the cases were followed up from 5 to 52 months. There were no collapsing cases in the bone-grafting group after operation,but 3 cases occurrenced re-collapsing in the non-bone-grafting group. According to the ZHANG Tie-liang's evaluation criterion,in the bone-grafting group,the results were excellent in 43 cases,good in 12,fair in 1,the fineness rate was 98.2%. In the non-bone-grafting group,the results were excellent in 37 cases,good in 16,fair in 2,poor in 1,the fineness rate was 94.7%.
Conclusion: Treatment of the typeⅡfracture of calcaneus with closed reduction,percutaneous K-wire fixation and mini-traumatic bone-grafting can prevent the posterior talar articular surface of caltaneus from collapsing again after operation,enhance the union of fracture,elevate the curative effect,thus it should be taken with the standard therapeutic regimen. |
| KEYWORDS:Calcaneal fractures Fracture fixation, internal Bone transplantation Retrospective studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 聂伟志,孙磊,杨茂清,谭远超,朱惠芳.跟骨骨折经皮穿针小切口植骨与非植骨治疗的比较研究[J].中国骨伤,2009,22(1):1~3 |
| 英文格式: | NIE Wei-zhi,SUN Lei,YANG Mao-qing,TAN Yuan-chao,ZHU Hui-fang.Comparison between mini-traumatic bone-grafting and non-bone-grafting in percutaneous K-wire fixation to treat the calcaneal fractures[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(1):1~3 |
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