| 余兰伟,张祝辉,邱华骥,王清玉,陈妍,李良华,韩大为.跗骨窦切口辅助Ilizarov技术与切开复位内固定治疗SandersⅢ、Ⅳ型跟骨骨折的疗效比较[J].实用中西医结合临床,2021,21(8): |
| 跗骨窦切口辅助Ilizarov技术与切开复位内固定治疗SandersⅢ、Ⅳ型跟骨骨折的疗效比较 |
| Comparison of Ilizarov technique assisted by tarsal sinus incision and ORIF in the treatment of Sanders type III and IV calcaneal fracturesYu Lanwei,Zhang Zhuhui,Qiu Huaji,Wang Qingyu,Chen Yan,Li Lianghua,Han Dawei |
| 投稿时间：2021-03-01 修订日期：2021-03-16 |
| DOI： |
| 中文关键词: 跟骨 骨折 Ilizarov技术 外固定架 跗骨窦切口 |
| 英文关键词: calcaneus fracture Ilizarov technique external fixator tarsal sinus incision |
| 基金项目:]福建省教育厅中青年教师教育科研项目(科技类)(编号：JAT190257) |
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| 中文摘要: |
| 目的 探讨跗骨窦切口辅助Ilizarov技术治疗SandersⅢ、Ⅳ型跟骨骨折的疗效。方法 2013年6月～2019年12月治疗40例(45足)SandersⅢ、Ⅳ型跟骨骨折患者,男34例,女6例。16例17足采用跗骨窦切口辅助Ilizarov技术(微创外架组),24例28足采用经外侧“L”形切口切开复位钢板内固定术(切开钢板组)。对比两组患者的手术一般情况、手术前后的影像学变化和术后的患足功能、疼痛情况。结果 至末次随访时,所有病例均达到骨性愈合：微创外架组愈合时间平均(11.77±3.13)周；切开钢板组愈合时间平均(12.02±2.97)周,无统计学差异。术前两组患者的患侧影像学测量结果对比无统计学差异。微创外架组等待手术时间、止血带时间、手术时间和手术出血量均比切开钢板组短(少),有统计学差异。两组跟骨的解剖参数和功能评分相比,无统计学差异。但在AOFAS评分、SF-36评分上,两组相比,微创外架组均数更高。结论 跗骨窦切口辅助复位Ilizarov技术治疗SandersⅢ、Ⅳ型跟骨骨折可取得与切开复位内固定相似的疗效,是治疗难复性跟骨关节内骨折的一种良好选择。 |
| 英文摘要: |
| Objective To investigate the clinical effect of Ilizarov technique assisted by tarsal sinus incision in the treatment of Sanders type III and IV calcaneal fractures. Methods From June 2013 to December 2019, 40 patients (45 feet) with Sanders type III and IV calcaneal fractures were treated, including 34 males and 6 females. 17 feet of 16 cases were treated with Ilizarov technique assisted by tarsal sinus incision (minimally invasive external fixation group), and 28 feet of 24 cases were treated with open reduction and plate fixation through lateral "L" incision (open plate group). The general situation of operation, imaging changes before and after operation, and postoperative foot function and pain were compared between the two groups. Results At the last follow-up, all cases achieved bone healing: the average healing time of minimally invasive external fixation group was (11.77 ± 3.13) weeks; the average healing time of open plate group was (12.02 ± 2.97) weeks, there was no significant difference. There was no significant difference in the imaging measurement results of the affected side between the two groups before operation. The waiting time, tourniquet time, operation time and blood loss of minimally invasive external fixator group were shorter than those of open plate group (less), with statistical difference. There was no significant difference in the anatomical parameters and functional scores of calcaneus between the two groups. However, the AOFAS score and SF-36 score of the two groups were higher than that of the minimally invasive external fixator group. Conclusion The treatment of Sanders type III and IV calcaneal fractures with Ilizarov assisted by tarsal sinus incision can achieve a similar effect with open reduction and internal fixation. It is a good choice for the treatment of intra-articular fractures of the calcaneus. |
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