| 老年跟骨关节内移位骨折的手术治疗 |
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Received:July 25, 2010
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| 作者 | Author | 单位 | Unit | E-Mail |
| 余华晨 |
YU Hua-chen |
温州医学院附属第二医院骨科，浙江 温州 325007 |
Department of Orthopaedics, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325007, Zhejiang, China |
huachenyu@126.com |
| 吴剑彬 |
WU Jian-bin |
温州医学院附属第二医院骨科，浙江 温州 325007 |
Department of Orthopaedics, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325007, Zhejiang, China |
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| 陈华 |
CHEN Hua |
温州医学院附属第二医院骨科，浙江 温州 325007 |
Department of Orthopaedics, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325007, Zhejiang, China |
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| 赵友明 |
ZHAO You-ming |
温州医学院附属第二医院骨科，浙江 温州 325007 |
Department of Orthopaedics, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325007, Zhejiang, China |
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| 陈临炜 |
CHEN Lin-wei |
温州医学院附属第二医院骨科，浙江 温州 325007 |
Department of Orthopaedics, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325007, Zhejiang, China |
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| 期刊信息：《中国骨伤》2010年23卷，第11期，第818-820页 |
| DOI：10.3969/j.issn.1003-0034.2010.11.007 |
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目的：观察老年跟骨关节内移位骨折手术治疗的临床疗效，探讨其手术指征。
方法：2000年1月至2007年12月，切开复位内固定治疗老年跟骨关节内移位骨折24例26足，男18例18足，女6例8足；年龄60～75岁，平均67岁。按Sanders分型，Ⅱ型13足，Ⅲ型12足，Ⅳ型1足。术前和术后测量跟骨结节关节角(B?hler角)和跟骨交叉角(Gissane角).采用Maryland足部评分系统评分。
结果：24例26足均获得随访，时间12～26个月，平均18.4个月。B?hler角术前平均(10.4±8.2)°，术后平均(27.8±7.4)°；Gissane角术前平均(136.5±10.3)°，术后平均(124.3±4.2)°；手术前后差异均有统计学意义(P<0.05).患足功能优5 足，良16 足，中4足，差1足。术后12足出现并发症，其中3足皮肤坏死，2足创口感染，1足腓肠神经损伤和6足创伤性距下关节炎。
结论：老年跟骨关节内移位骨折患者经手术治疗均能取得较好的临床效果。只要全身情况允许，老年跟骨关节内移位骨折应行切开复位内固定治疗。 |
| [关键词]:跟骨 骨折 骨折固定术，内 老年人 |
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| Surgical treatment of displaced intra-articular fractures of the calcaneus in elderly patients |
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Abstract:
Objective: To study the clinical effects of surgical treatment of displaced intra-articular fractures of the calcaneus in elderly patients,and to discuss the operative indications.
Methods: From January 2000 to December 2007,24 elderly patients with 26 fractures underwent open reduction and internal fixation for a displaced intra-articular fracture of calcaneus,which included 18 feet of 18 males and 8 feet of 6 female,with an average age of 67 years (range,60 to 75 years). According to Sanders classification based on CT scanning,13 fractures were rated as typeⅡ，12 as typeⅢand 1 as typeⅣ。 B?hler angle and Gissane angle were measured preoperatively and postoperatively and foot function was assessed with Maryland foot score system.
Results: Twenty-four cases with 26 feet were followed up for an average of 18.4 months(range,12 to 26 months). Mean B?hler angle was(10.4±8.2)° preoperatively and(27.8±7.4)° postoperatively and mean Gissane angle was (136.5±10.3)° preoperatively and(124.3±4.2)° postoperatively. The difference between preoperative and postoperative values was found with statistically significant(P<0.05). The results were excellent in 5 feet,good in 16 feet,fair in 4 feet and poor in 1 foot. There were 3 cases of wound necerosis,2 cases of wound infection,1 case of sural nerve injury and 6 cases of posttraumatic subtalar arthritis complications.
Conclusion: Good clinical result could be obtained with surgical treatment in elderly patients with displaced intra-articular fractures of the calcaneus. Open reduction appears to be an acceptable method of treatment for displaced calcaneal fractures in elderly patients if they have good general conditions. |
| KEYWORDS:Calcaneus Fractures Fracture fixation,internal Aged |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 余华晨,吴剑彬,陈华,赵友明,陈临炜.老年跟骨关节内移位骨折的手术治疗[J].中国骨伤,2010,23(11):818~820 |
| 英文格式: | YU Hua-chen,WU Jian-bin,CHEN Hua,ZHAO You-ming,CHEN Lin-wei.Surgical treatment of displaced intra-articular fractures of the calcaneus in elderly patients[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(11):818~820 |
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