经跗骨窦切口空心钉和微型锁定钢板内固定治疗跟骨骨折的疗效比较

发布时间：2018-01-28 03:56

本文关键词： 跟骨骨折跗骨窦切口空心钉微型锁定钢板　出处：《安徽医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的探讨经跗骨窦切口采用空心钉及微型锁定钢板治疗跟骨骨折能否达到稳定内固定效果及两种内固定方式之间的差别。方法采取回顾性病例对照研究设计方案,从2014年3月至2016年1月于我院创伤骨科接受跟骨骨折手术治疗的患者中筛选符合研究标准的病例,采用跗骨窦切口空心钉和微型锁定钢板内固定治疗跟骨骨折,收集病例58例患者共63足,全部为闭合性骨折,未合并糖尿病,周围血管性疾病及其他严重基础疾病。其中采用跗骨窦切口+空心钉内固定36足(33人,A组),采用跗骨窦切口+微型锁定钢板内固定27足(26人,B组)。采集两组患者基本资料,对比手术前与随访时跟骨的高度、宽度、轴长、B?hler角以及Gissane角的变化情况,术前等待时间,手术时间,术后并发症的发生率。采用Maryland评分(MFS)来评价最终手术效果。结果两组患者术前一般资料比较(性别,年龄,术前等待时间,Sanders分型,致伤原因,术前跟骨宽度、高度、轴长、B?hler角、Gissane角)进行比较,两组间差别无统计学意义(P0.05)。A组手术时间较B组短(P0.05);随访时两组跟骨宽度、高度、轴长、B?hler角、Gissane角较术前都有明显改善(P0.05),组间比较差异无统计学意义(P0.05);Sanders II型Maryland足部评分无明显差异(P0.05),SandersⅢ型空心钉组评分较钢板组差。结论采用空心钉或者微型锁定钢板两种手术方式治疗跟骨关节内骨折随访时跟骨宽度、高度、轴长、B?hler角和Gissane角都较术前明显改善,对于SandersⅡ型患者,两组手术疗效无明显差异;对于SandersⅢ型患者,微型锁定钢板内固定临床效果优于空心钉内固定,对跟骨骨折内固定方式的选择具有一定的指导意义。空心钉内固定方式手术时间较微型钢板短。
[Abstract]:Objective to investigate the incision of the tarsal sinus between hollow screws and mini locking plate for treatment of calcaneal fractures can achieve stable fixation and the effect of two kinds of internal fixation methods. The difference between the methods of retrospective control study design cases, from March 2014 to January 2016 in the Department of orthopedics of our hospital trauma surgery for the treatment of calcaneal fracture patients were met the study criteria the cases of tarsal sinus and micro incision cannulated screw locking plate fixation of calcaneal fractures, 58 cases of patients with a total of 63 foot, all fractures were closed, without diabetes, peripheral vascular disease and other serious underlying disease. The tarsal sinus incision and cannulated screw fixation (36 foot 33, A the tarsal sinus group), incision Mini locking plate fixation + 27 foot (26, B). The two groups were collected the basic information of height and follow-up calcaneal contrast before surgery, width B, axial length, hler angle and Gissane? Change angle, waiting time, operative time, postoperative complication rate. The Maryland score (MFS) to evaluate the effect of the operation. The final results of two groups of patients before general data (sex, age, waiting time, preoperative Sanders typing the causes of injury, preoperative, calcaneal width, height, length, B? Hler angle, Gissane angle) were compared, the difference between the two groups was not statistically significant (P0.05) the operation time of.A group was shorter than that of group B (P0.05); two groups of calcaneal width, height, length, hler angle B?, Gissane angle before and after operation were obviously improved (P0.05), there was no significant difference between groups (P0.05); no significant difference between the Sanders type II Maryland foot score (P0.05), Sanders type hollow nail group score than plate group. Conclusion using cannulated screws or locking type micro surgical methods of two plate treatment the follow-up of intra-articular calcaneal fractures When the calcaneal width, height, length, B angle and Gissane? Hler are significantly improved compared with preoperative, Sanders for type II patients, no significant difference in efficacy for the operation of two groups; Sanders patients with type III, mini locking plate fixation is better than the clinical effect of cannulated screw fixation, has certain guiding significance to the internal fracture of calcaneus the choice of fixation methods. Hollow screw fixation with mini plate operation time is short.

【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

【参考文献】