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外固定架结合有限内固定治疗复杂跟骨骨折
Hits: 2055   Download times: 1237   Received:December 18, 2009    
作者Author单位UnitE-Mail
李明辉 LI Ming-hui 武汉市第五医院骨科,湖北 武汉 430050 Department of Orthopaedics,the Fifth Hospital of Wuhan,Wuhan 430050,Hubei,China lmh061127@163.com 
刘洋 LIU Yang 武汉市第五医院骨科,湖北 武汉 430050 Department of Orthopaedics,the Fifth Hospital of Wuhan,Wuhan 430050,Hubei,China  
期刊信息:《中国骨伤》2010年23卷,第3期,第217-219页
DOI:10.3969/j.issn.1003-0034.2010.03.022


目的:观察调节式外固定支架结合普通螺钉、克氏针等有限内固定方法治疗复杂跟骨骨折(SandersⅢ、Ⅳ型)的临床疗效。

方法:自2003年1月至2008年6月采用外固定支架结合普通螺钉、克氏针等有限内固定方法治疗27例36足(左侧19足,右侧17足)SandersⅢ、Ⅳ型复杂跟骨骨折患者(年龄17~65岁,平均37岁),患足术前均行X线及CT检查,并按Crosby-Fitzgibbons-Sanders分类法进行分组, 术后B?觟hler角和Gissane角的改变采用X线片进行分析,功能状况采用张铁良跟骨骨折综合评分法进行评定。

结果:36足中32足获得随访,时间为11~24个月,平均13个月,B?觟hler角和Gissane角分别由术前平均(8.0±7.3)°及(130.5±10.5)°,恢复到术后平均(29.6±7.4)°及(122.5±8.6)°。采用张铁良跟骨骨折综合评分法评为优17足,良8足,中5足,差2足。3足因手术发生伤口感染或皮缘坏死,经负压封闭引流术或伤口换药后获得愈合。

结论:外固定架结合有限内固定治疗复杂跟骨骨折具有并发症少、功能恢复好等优点,能有效治疗复杂跟骨骨折。
[关键词]:跟骨  骨折  外固定器  骨折固定术,内
 
Treatment of complex calcaneal fractures with external fixator and limited internal fixation
Abstract:

Objective: To study the clinical effects of the adjustable external fixation combined with the limited internal fixation such as ordinary screws,Kirschner wire fixation for the treatment of complex calcaneal fractures(SandersⅢ,Ⅳ).

Methods: From January 2003 to June 2008,27 patients 36 feet(19 feet in the left and 17 feet in the right) with calcaneal fractures of Sanders Ⅲ and Ⅳ(the age ranged from 17 to 65 years,mean 37 years)were treated with external fixator combined with ordinary screws and Kirschner wire fixation. All the patients were undergone X-ray and CT examinations and classified by Crosby-Fitzgibbons-Sanders. The changes of the B?觟hler and Gissane angles were analyzed by X-ray. The functional of the feet was assessed by ZHANG Tie-liang calcaneal fractures scoring system.

Results: Thirty-two feet were followed up for 11 to 24 months,with an average of 13 months. The B?觟hler and Gissane angles changed from average(8.0±7.3) degree and(130.5±10.5) degree,back to postoperative(29.6±7.4) degree and (122.5±8.6) degree. According to ZHANG Tie-liang scoring system,the result was excellent in 17 feet,good in 8 feet,fair in 5 feet and not satisfied with 2 feet. Three feet with wound infection or skin flap necrosis were healed after vacuum sealing drainage or wound dressing.

Conclusion: The combination of external fixator and limited internal fixation is an effective treatment for complex calcaneal fractures with few complications and good functional recovery.
KEYWORDS:Calcaneus  Fractures  External fixators  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:李明辉,刘洋.外固定架结合有限内固定治疗复杂跟骨骨折[J].中国骨伤,2010,23(3):217~219
英文格式:LI Ming-hui,LIU Yang.Treatment of complex calcaneal fractures with external fixator and limited internal fixation[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(3):217~219
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