应用跟骨塑形复位钳联合外固定架闭合治疗跟骨骨折

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目的:研究应用跟骨塑形复位钳联合外固定架闭合螺纹针微创治疗跟骨骨折的临床效果。方法:回顾性分析2015年1月至2017年12月大连大学附属中山医院收治的16例单侧跟骨骨折患者临床资料,其中男14例,女2例;于术前、术后3 d和术后6个月测量Bohler角、Gissane角、跟骨宽度、高度、长度,术后6、12个月根据美国足踝外科协会(AOFAS)评分评价踝关节功能。结果:术后3 d和6个月Bohler角、Gissane角、高度、长度、宽度均较术前明显改善[(28.82 ± 1.72)°和(25.84 ± 1.96)°比(16.71 ± 2.74)°、(120.92 ± 3.85)°和(119.65 ± 3.84)°比(103.63 ± 4.62)°、(35.23 ± 1.94)和(36.51 ± 2.01)mm比(39.52 ± 1.26)mm、(48.52 ± 2.16)和(48.86 ± 1.98)mm比(46.94 ± 2.48)mm、(71.23 ± 2.49)和(70.94 ± 2.36)mm比(67.53 ± 2.53)mm],差异有统计学意义(n P0.05)。术后12个月平均AOFAS评分明显高于术后6个月(80.6分比60.1分),差异有统计学意义(n P<0.01)。在最后的随访AOFAS评分中,获优11例,良3例,中1例,差1例,优良率14/16。术后6个月平均AOFAS评分60.1分,12个月AOFAS最后随访平均评分明显高于术后6个月平均AOFAS评分(80.6分比60.1分)(n P < 0.01)。在最后的随访AOFAS评分中,获优11例,良3例,中1例,差1例。n 结论:应用跟骨塑形复位钳联合外固定架闭合螺纹针撬拨复位可有效治疗移位跟骨骨折,具有操作简单、创伤小、有效减少皮肤软组织等并发症,临床效果满意。“,”Objective:To study the clinical effect of the minimally invasive treatment of calcaneal fractures by closed reduction using calcaneal plastic reduction forceps combined with threaded-pin external fixation.Methods:Clinical data of 16 patients with unilateral calcaneal fractures admitted to Affiliated Zhongshan Hospital of Dalian University from January 2015 to December 2017, including 14 males and 2 females, with a unilateral calcaneal fracture were analyzed retrospectively. The Bohler angle, Gissane angle, and calcaneal width, height and length were measured before and after the operation. The ankle function was evaluated according to the AOFAS score at 6 and 12 months after the operation.Results:The Bohler angle, Gissane angle, width, height and length 3 d and 6 months after operation were significantly better than before operation: (28.82 ± 1.72)° and (25.84 ± 1.96)° vs. (16.71 ± 2.74)°, (120.92 ± 3.85)° and (119.65 ± 3.84)° vs. (103.63 ± 4.62)°, (35.23 ± 1.94) and (36.51 ± 2.01) mm vs. (39.52 ± 1.26) mm, (48.52 ± 2.16) and (48.86 ± 1.98) mm vs. (46.94 ± 2.48) mm, (71.23 ± 2.49) and (70.94 ± 2.36) mm vs. (67.53 ± 2.53) mm, there were statistical differences (n P0.05). The average AOFAS score 12 months after operation was significantly higher than 6 months after operation (80.6 scores vs. 60.1 scores), there was statistical difference (n P<0.01). At the final follow-up, the AOFAS score was excellent, good, moderate, and poor in 11 cases, 3 cases, 1 case and 1 case. The average AOFAS score was 60.1 at 6 months after the operation and 80.6 at 12 months after the operation, which was significantly higher than the average AOFAS score at 6 months after the operation (n P < 0.01). At the final follow-up, the AOFAS score was excellent, good, moderate, and poor in 11 cases, 3 cases, 1 case and 1 case, respectively.n Conclusions:The application of closed reduction using calcaneal plastic reduction forceps combined with threaded-pin external fixation is effective for the treatment of displaced calcaneal fractures, with a simple procedure, minimal trauma, fewer skin and soft tissue complications, and satisfactory clinical results.
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