经跟骨外侧“八”字切口治疗跟骨骨折
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摘要
目的:研究经跟骨外侧"八"字切口行跟骨骨折钢板内固定手术的效果。方法:选取24例跟骨骨折患者为研究对象,采用跟骨外侧"八"字切口行跟骨骨折钢板内固定手术。结果:术后12~24个月,对24位患者(26足)随访,患者骨折均愈合,均未发生切口皮肤坏死、骨髓炎等严重并发症。按AOFAS评分标准评价,优15足,良8足,可2足,差1足,优良率为88.46%。结论:经跟骨外侧"八"字切口行跟骨骨折钢板内固定手术,术中关节能得到良好显示,易于复位,术后皮肤坏死等并发症少,疗效较好。
Objective:To study the effect of internal fixation of calcaneal fracture with "Eight" type incision of the calcaneus.Method:26 cases of calcaneal fractures were selected as the objects of the study and treated with lateral calcaneal "Eight" type incision line calcaneal fracture plate internal fixation surgery.Result:All of the 24 patients(26 feet) were followed up for 12 to 24 months after operation and the fracture healed.No severe complications such as skin necrosis of the incision and osteomyelitis or other serious complications were found.According to AOFAS score evaluation,excellent in 15 feet,good in 8 feet,well in 2 feet,poor in 1 foot,the excellent and good rate of 88.46%.Conclusion:Through lateral calcaneus,"Eight" type incision for calcaneal fracture plate fixation,the intraoperative joint can be well displayed,easy to reset,postoperative skin necrosis and other complications less,and the curative effect is better.
Objective:To study the effect of internal fixation of calcaneal fracture with "Eight" type incision of the calcaneus.Method:26 cases of calcaneal fractures were selected as the objects of the study and treated with lateral calcaneal "Eight" type incision line calcaneal fracture plate internal fixation surgery.Result:All of the 24 patients(26 feet) were followed up for 12 to 24 months after operation and the fracture healed.No severe complications such as skin necrosis of the incision and osteomyelitis or other serious complications were found.According to AOFAS score evaluation,excellent in 15 feet,good in 8 feet,well in 2 feet,poor in 1 foot,the excellent and good rate of 88.46%.Conclusion:Through lateral calcaneus,"Eight" type incision for calcaneal fracture plate fixation,the intraoperative joint can be well displayed,easy to reset,postoperative skin necrosis and other complications less,and the curative effect is better.
引文
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[2]Sanders R.Displaced intra-articular fractures of the calcaneus[J].J Bone Joint Surg Am,2000,82(2):225-250.
[3]董玉金,童致虹,张铁慧,等.锁定加压钛板内固定治疗跟骨骨折[J].中华骨科杂志,2013,33(4):315-319.
[4]Kitaoka H B,Alexander I J,Adelaar R S,et al.Clinical rating systems for the ankle-hindfoot,midfoot,hallux and lesser toes[J].Foot Ankle Int,1994,15(7):349-353.
[5]周颖,顾向军,马一平,等.八字切口异形钢板治疗跟骨骨折的疗效分析[J].中国矫形外科杂志,2016,24(8):754-756.
[6]瞿浩,魏世隽,蔡贤华,等.SandersⅢ型跟骨骨折解剖学指标的改变与术后疗效的关系[J].中国矫形外科杂志,2014,22(12):1057-1062.
[7]陈杰,曹立海,李绍光,等.粉碎性跟骨骨折手术切口的选择[J].中国骨与关节损伤杂志,2013,28(12):1206-1207.
[8]谭新欢,聂伟志,朱育林,等.跟骨骨折微创治疗的研究进展[J].中医正骨,2015,27(5):73-75.
[9]郝东升,陈晨,王东,等.跟骨骨折外侧延长L形切口并发症非手术相关危险因素分析[J].中国修复与重建外科杂志,2013,27(1):30-35.
[10]李魁章,施宏宇,王鑫,等.跟骨骨折术后皮肤坏死骨外露原因及治疗预防措施临床分析[J].生物骨科材料与临床研究,2015,12(3):70-72.
[11]麻文谦,董晖,杨晓东,等.腓肠神经营养血管皮瓣逆行修复跟骨骨折术后小面积骨钢板外露[J].中华显微外科杂志,2014,37(2):178-179.
[12]Rubino R,Valderrabano V,Sutter P M,et al.Prognostic value of four classifications of calcaneal fractures[J].Foot Ankle Int,2009,30(3):229-238.
[13]郭世绂.骨科临床解剖学[M].济南:山东科学技术出版社,2001:1035.
[14]冉党红,祝先锋,刘玉春,等.微创八字形切口钢板内固定治疗跟骨骨折[J].中国骨与关节损伤杂志,2014,29(12):1296-1297.
[15]祝海炳,李哲民,施忠民,等.小切口微型锁定钢板与传统切口钢板内固定治疗跟骨关节内骨折的对照研究[J].浙江医学,2014,36(1):19-22.
[16]冯炜,李俊杰,俞立新,等.经“八”字切口微创固定治疗跟骨关节内骨折[J].临床骨科杂志,2016,19(4):485-486.
[17]孙昌俊,李力更,毕若杰,等.“L”入路与“八字”微创入路治疗跟骨骨折的比较[J].中国医学科学院学报,2015,37(6):733-736.
[18]刘洪达,曲平艳,高建华,等.改良“八”字切口治疗跟骨骨折合并腓骨肌腱滑脱的体会[J].中国骨与关节损伤杂志,2016,31(4):437-438.
[2]Sanders R.Displaced intra-articular fractures of the calcaneus[J].J Bone Joint Surg Am,2000,82(2):225-250.
[3]董玉金,童致虹,张铁慧,等.锁定加压钛板内固定治疗跟骨骨折[J].中华骨科杂志,2013,33(4):315-319.
[4]Kitaoka H B,Alexander I J,Adelaar R S,et al.Clinical rating systems for the ankle-hindfoot,midfoot,hallux and lesser toes[J].Foot Ankle Int,1994,15(7):349-353.
[5]周颖,顾向军,马一平,等.八字切口异形钢板治疗跟骨骨折的疗效分析[J].中国矫形外科杂志,2016,24(8):754-756.
[6]瞿浩,魏世隽,蔡贤华,等.SandersⅢ型跟骨骨折解剖学指标的改变与术后疗效的关系[J].中国矫形外科杂志,2014,22(12):1057-1062.
[7]陈杰,曹立海,李绍光,等.粉碎性跟骨骨折手术切口的选择[J].中国骨与关节损伤杂志,2013,28(12):1206-1207.
[8]谭新欢,聂伟志,朱育林,等.跟骨骨折微创治疗的研究进展[J].中医正骨,2015,27(5):73-75.
[9]郝东升,陈晨,王东,等.跟骨骨折外侧延长L形切口并发症非手术相关危险因素分析[J].中国修复与重建外科杂志,2013,27(1):30-35.
[10]李魁章,施宏宇,王鑫,等.跟骨骨折术后皮肤坏死骨外露原因及治疗预防措施临床分析[J].生物骨科材料与临床研究,2015,12(3):70-72.
[11]麻文谦,董晖,杨晓东,等.腓肠神经营养血管皮瓣逆行修复跟骨骨折术后小面积骨钢板外露[J].中华显微外科杂志,2014,37(2):178-179.
[12]Rubino R,Valderrabano V,Sutter P M,et al.Prognostic value of four classifications of calcaneal fractures[J].Foot Ankle Int,2009,30(3):229-238.
[13]郭世绂.骨科临床解剖学[M].济南:山东科学技术出版社,2001:1035.
[14]冉党红,祝先锋,刘玉春,等.微创八字形切口钢板内固定治疗跟骨骨折[J].中国骨与关节损伤杂志,2014,29(12):1296-1297.
[15]祝海炳,李哲民,施忠民,等.小切口微型锁定钢板与传统切口钢板内固定治疗跟骨关节内骨折的对照研究[J].浙江医学,2014,36(1):19-22.
[16]冯炜,李俊杰,俞立新,等.经“八”字切口微创固定治疗跟骨关节内骨折[J].临床骨科杂志,2016,19(4):485-486.
[17]孙昌俊,李力更,毕若杰,等.“L”入路与“八字”微创入路治疗跟骨骨折的比较[J].中国医学科学院学报,2015,37(6):733-736.
[18]刘洪达,曲平艳,高建华,等.改良“八”字切口治疗跟骨骨折合并腓骨肌腱滑脱的体会[J].中国骨与关节损伤杂志,2016,31(4):437-438.