摘要
目的:探讨手法复位联合跗骨窦切口微创钢板内固定治疗跟骨骨折的临床疗效。方法:36例单侧跟骨骨折患者,均采用手法复位联合跗骨窦切口微创钢板内固定治疗,通过影像学检查对术前、术后3天及术后一年的跟骨Bohler角、Gissane角及跟骨轴位角进行统计学分析,同时按Maryland足部评分系统对患者治疗后功能恢复进行评价。结果:所有患者均随访1年,且均骨性愈合。跟骨Bohler角术前平均为(13.9±3.5),术后3天平均为(25.0±4.0);跟骨Gissane角术前平均为(108.9±8.5),术后3天平均为(127.2±6.8);跟骨轴位角术前平均为(24.2±1.8),术后3天平均为(17.5±1.2);术前及术后3天的跟骨Bohler角、Gissane角及跟骨轴位角比较,差异均有统计学意义(P<0.05);跟骨Bohler角术后3天平均为(25.0±4.0),术后1年平均为(24.8±3.8),跟骨Gissane角术后3天平均为(127.2±6.8),术后1年平均为(127.1±6.3),跟骨轴位角术后三天平均为(17.5±1.2),术后3天平均为(17.7±1.2);术后3天及术后1年的跟骨Bohler角、Gissane角及跟骨轴位角比较,差异均无统计学意义(P>0.05)。根据Maryland足部评分系统标准进行评定,优24例,良足6例,可5例,差1例,优良率为83.3%。结论:手法联合跗骨窦切口微创钢板内固定治疗SandersⅡ、Ⅲ跟骨骨折具有简化复位程序、缩短复位时间、减少软组织再损伤的特点,其中中医手法使复位技术进一步微创化,临床效果满意。
Objective: To investigate the clinical effect of manual reduction combined with minimally invasive plate internal fixation through tarsal sinus incision in the treatment of calcaneal fracture. Methods 36 patients with unilateral calcaneal fracture were treated with manual reduction combined with minimally invasive plate internal fixation through tarsal sinus incision. The Bohler angle, Gissane angle and calcaneal axis angle of calcaneus before operation, 3 days after operation and 1 year after operation were analyzed by radiological examination. At the same time, the patients’post-treatment success was evaluated by Maryland foot scoring system. It can be restored and evaluated. Results All patients were followed up for 1 year and all healed. The average Bohler angle of calcaneus was( 13.9 ±3.5) before operation and( 25.0 ±4.0) 3 days after operation;the average Gissane angle of calcaneus was( 108.9 ±8.5) before operation and( 127.2 ±6.8) 3 days after operation;the average calcaneal axis angle was( 24.2 ±1.8) before operation and( 17.5 ±1.2) 3 days after operation;the average Bohler angle and Gissane angle of calcaneus before and 3 days after operation were( 17.5 ±1.2). There were significant differences between Gissane angle and calcaneal axis angle( P < 0.05). The average calcaneal Bohler angle was( 25.0 ±4.0) 3 days after operation, 24.8 ±3.8) 1 year after operation, 127.2±6.8) 3 days after operation, 127.1 ±6.3) 1 year after operation, and( 1.1 ±6.3) 3 days after operation. There was no significant difference in calcaneal Bohler angle, Gissane angle and calcaneal axis angle between 3 days after operation and 1 year after operation( P > 0.05). According to Maryland’s foot scoring system, 24 cases were excellent, 6 cases were good, 5 cases were fair and 1 case was poor. The excellent and good rate was 83.3%. Conclusion Manipulation combined with tarsal sinus incision minimally invasive plate internal fixation for Sanders II and III calcaneal fractures has the characteristics of simplifying reduction procedure, shortening reduction time and reducing soft tissue re-injury. Traditional Chinese medicine manipulation makes reduction technique more minimally invasive, and the clinical effect is satisfactory.
作者
周启俊
孙从松
潘大群
汤海波
ZHOU Qijun;SUN Congsong;PAN Daqun;TANG Haibo(Wuwei County People's Hospital, Anhui Wuhu 238300, China)
出处
《中医药临床杂志》
2019年第8期1595-1597,共3页
Clinical Journal of Traditional Chinese Medicine
关键词
手法复位
跗骨窦切口
微创
内固定
跟骨骨折
Manual reduction
Tarsal sinus incision
Minimally invasive
Internal fixation
Calcaneal fracture
