【摘要】 目的比较闭合复位无头加压螺钉与切开复位钛板螺钉内固定治疗SandersⅡ、Ⅲ型跟骨骨折的临床疗效。方法回顾性分析自2015-01—2016-05诊治的56例(60足)SandersⅡ、Ⅲ型跟骨骨折,28例(30足)采用闭合复位无头加压螺钉内固定治疗(观察组),28例(30足)采用切开复位解剖型钛板螺钉内固定治疗(对照组)。比较2组术前准备时间、术中复位情况(Bohler角、Gissane角、跟骨宽度)、手术时间、住院时间、术后并发症情况,以及末次随访时AOFAS评分。结果 56例均获得随访,随访时间平均11.2(10~14)个月。观察组术前准备时间、手术时间、住院时间均短于对照组,术后早期切口并发症明显更少,差异有统计学意义(P<0.05)。但2组Bohler角、Gissane角、跟骨宽度、末次随访时AOFAS评分比较差异无统计学意义(P>0.05)。结论对于SandersⅡ型和大部分未粉碎的Ⅲ型跟骨骨折,闭合复位无头加压螺钉内固定可以进行微创操作,术中复位固定可靠,术后并发症少,患者进行系统康复训练后功能恢复满意。更多还原

【Abstract】 Objective To compare the clinical outcomes between closed reduction hollow screw fixation and titanic plate screw fixation for the treatment of Sanders type Ⅱ and Ⅲ calcaneal fractures. Methods From January 2015 to May 2016,total 56 cases(60 feet) of the Sanders type Ⅱ and Ⅲ calcaneal fractures were enrolled in the study. Twenty-eight patients(30 feet) were surgically treated by closed reduction hollow screw fixation as observation group, while the other 28 patients(30 feet) were treated with anatomic calcaneal titanic plate screw fixation as control group. The preoperative preparation time,intraoperative reduction(Bohler angle, Gissane angle, calcaneal width), operation time, hospital stay, postoperative complications, and AOFAS score at the final follow-up were compared between the two groups. Results Fifty-six patients were followed up for 11.2 months averagely(10-14 months). The preoperative preparation time, operation time, hospital stay of the observation group was shorter than those of the control group. And the incision complications of the observation group were significantly lower in the early postoperative period and the difference was statistically significant( P <0.05). However, there was no significant difference in the Bohler angle, Gissane angle, calcaneal width, and AOFAS scores at the last follow-up between the two groups(P >0.05). Conclusion For Sanders type Ⅱ and most uncrushed type Ⅲ calcaneal fractures, closed reduction headless compression screws fixation can be achieved through minimally invasive procedures, reduction and fixation are reliable during surgery, complications after operation are less, and patients’ functional recovery is satisfactory after systemic rehabilitation training.更多还原