| 外固定架结合有限内固定治疗复杂跟骨骨折 |
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Received:December 18, 2009
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| 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 |
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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 |
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| Treatment of complex calcaneal fractures with external fixator and limited internal fixation |
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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 |
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| 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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