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经皮克氏针撬拨复位内固定治疗儿童跟骨关节内骨折的疗效分析
Hits: 2527   Download times: 1360   Received:April 11, 2011    
作者Author单位UnitE-Mail
黄忠胜 HUANG Zhong-sheng 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,the Affiliated Yueqing Hospital of Wenzhou Medical College,Wenzhou 325600,Zhejiang,China  
赵政 ZHAO Zhen 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,the Affiliated Yueqing Hospital of Wenzhou Medical College,Wenzhou 325600,Zhejiang,China  
季滢瑶 JI Ying-yao 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,the Affiliated Yueqing Hospital of Wenzhou Medical College,Wenzhou 325600,Zhejiang,China  
李科伦 LI Ke-lun 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,the Affiliated Yueqing Hospital of Wenzhou Medical College,Wenzhou 325600,Zhejiang,China  
郑钜晗 ZHENG Ju-han 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,the Affiliated Yueqing Hospital of Wenzhou Medical College,Wenzhou 325600,Zhejiang,China  
倪建光 NI Jian-guang 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,the Affiliated Yueqing Hospital of Wenzhou Medical College,Wenzhou 325600,Zhejiang,China  
徐粲臻 XU Can-zhen 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,the Affiliated Yueqing Hospital of Wenzhou Medical College,Wenzhou 325600,Zhejiang,China  
郑立程 ZHENG Li-cheng 温州医学院附属乐清医院骨科,浙江 温州 325600 Department of Orthopaedics,the Affiliated Yueqing Hospital of Wenzhou Medical College,Wenzhou 325600,Zhejiang,China zlcheng007@gmail.com 
期刊信息:《中国骨伤》2011年24卷,第10期,第834-837页
DOI:10.3969/j.issn.1003-0034.2011.10.010


目的: 介绍经皮克氏针撬拨复位内固定治疗儿童跟骨骨折,评估该方法的临床疗效。

方法: 2001年3月至2009年2月,采用经皮克氏针撬拨复位内固定治疗儿童跟骨关节内骨折12例(13足),其中男8例,女4例;年龄3~14岁,平均8.7岁。骨折按Essex-Lopresti分型:舌型骨折5足,压缩型骨折8足。按Sanders分型:Ⅱ型9足,Ⅲ型4足。手术前后摄X线片,比较跟骨Böhler角和Gissane角的恢复情况,疗效评价采用Maryland足部评分系统。

结果: 所有患者均获随访,时间16~71个月,平均35.9个月。骨折均获愈合,无创口愈合不良、坏死感染发生。术前Böhler角为(19.7±5.3)°,术后为(32.6±3.7)°;术前Gissane角为(137.3±7.5)°,术后为(125.4±2.9)°,上述影像学测量结果与术前比较差异均有统计学意义(P<0.01).Maryland评分92~100分,平均(96.3±2.4)分。

结论: 经皮克氏针撬拨复位内固定术,软组织损伤小、固定可靠、疗效满意,是儿童跟骨关节内骨折有效的微创治疗方法。
[关键词]:跟骨  骨折  儿童  骨折固定术,内
 
Effective analysis of percutaneous reduction and Kirschner pin fixation for the treatment of intraarticular fractures of the calcaneus in children
Abstract:

Objective: To introduce and evaluate the clinical effects of percutaneous reduction and Kirschner pin fixation for the treatment of intraarticular fractures of the calcaneus in children.

Methods: From March 2001 to February 2009,12 patients with intraarticular calcaneal fractures were treated by percutaneous reduction and Kirschner pin fixation(13 feet).There were 8 males and 4 females,ranging in age from 3 to 14,with an average of 8.7 years.According to Essex-Lopresti classification,among 5 feet were tongue fractures and 8 feet were compressed fractures.According to Sanders classification,9 feet were typeⅡand 4 feet were typeⅢ。 The Böhler angle and Gissane angle of the calcaneus were obtained before and after operation.All patients were evaluated according to Maryland Foot Score.

Results: All the patients were followed up for 16-71 months (means 35.9 months),and all the incisions were healed without complications and infection.The preoperative X-ray film showed that Böhler angle was(19.7±5.3)°,Gissane angle was(137.3±7.5)°。 The postoperative X-ray film demonstrated that Böhler angle was (32.6±3.7)°,Gissane angle was (125.4±2.9)°。 There was a significant difference between preoperative and postoperative (P﹤0.01).The average Maryland score was 96.3±2.4 (range,92 to 100 points).

Conclusion: Percutaneous reduction and Kirschner pin fixation is an effective minimally invasive way to treat intraarticular fractures of the calcaneus in children,it has many advantages such as minimal invasion,reliable fixation and satisfactory effects.
KEYWORDS:Calcaneus  Fractures  Children  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:黄忠胜,赵政,季滢瑶,李科伦,郑钜晗,倪建光,徐粲臻,郑立程.经皮克氏针撬拨复位内固定治疗儿童跟骨关节内骨折的疗效分析[J].中国骨伤,2011,24(10):834~837
英文格式:HUANG Zhong-sheng,ZHAO Zhen,JI Ying-yao,LI Ke-lun,ZHENG Ju-han,NI Jian-guang,XU Can-zhen,ZHENG Li-cheng.Effective analysis of percutaneous reduction and Kirschner pin fixation for the treatment of intraarticular fractures of the calcaneus in children[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(10):834~837
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