撬拨复位内固定配合接骨续筋口服液治疗跟骨骨折的临床研究

发布时间：2018-06-19 21:49

本文选题：微创撬拨复位 + 切开复位内固定　；参考：《安徽中医药大学》2015年硕士论文

【摘要】：目的:本研究以跟骨骨折的发病机制、诊治方法和并发症等理论研究为基础,通过比较微创撬拨复位空心钉内固定结合接骨续筋口服液方法和切开复位钢板内固定结合接骨续筋口服液方法治疗Sander II型和III型跟骨骨折的临床疗效,阐明微创撬拨复位空心钉内固定配合接骨续筋口服液治疗方法的优势,为其在临床上推广应用提供可靠依据。方法:本组研究共纳入Sander II型和III型跟骨骨折病例40例,随机分成两组,即治疗组和对照组各20例。其中治疗组予以微创撬拨复位空心钉内固定术治疗;对照组予以切开复位钢板螺钉内固定术治疗。在术后,两组病例均给予院内中药制剂(接骨续筋口服液)内服并配合功能锻炼。术后对患者行6~12个月的随访,通过对两者在手术时间、手术出血量、骨折愈合时间、术后并发症发生率以及手术前后功能恢复情况、影像学相关解剖角度复位情况等方面的对比,并将评估数据进行统计学分析处理,以此比较两种手术方法在治疗Sander II型和III型跟骨骨折的优劣性。结果:两种方法在临床上治疗Sander II型和III型跟骨骨折上均获得满意的治疗效果。其中在功能评分方面,治疗组和对照组相当(P0.05);在影像学解剖复位方面,治疗组和对照组没有明显差异(P0.05);但是,与对照组相比,治疗组在手术耗费时间、术中出血量、骨折愈合时间以及手术并发症发生率等方面具有明显的优势(P0.01)。结论:两种方法治疗Sander II型和III型跟骨骨折的临床疗效相当,均为有效可靠的治疗方法。但是,较切开复位钢板螺钉内固定术,微创撬拨复位空心钉内固定术具有手术操作相对简单、手术所需时间少、术中出血量少、愈合快、术后并发症少等优点;同时,由于较小的手术创伤相对减轻了患者的痛苦,使患者易于接受。因此,微创撬拨复位空心钉内固定术应在严格把握适应症的前提下,作为一种治疗跟骨骨折较好的方法在临床上推广应用。
[Abstract]:Objective: this study is based on the theoretical study of the pathogenesis, diagnosis and treatment of calcaneal fracture, and complications. To compare the clinical effects of minimally invasive prying reduction with hollow nail fixation combined with continuous bone joint oral liquid and open reduction plate fixation combined with bone graft oral liquid in the treatment of Sander type II and type III calcaneal fractures, and compared the clinical efficacy of the two methods in the treatment of Sander type II and type III calcaneal fractures. To expound the advantages of minimally invasive prying reduction and hollow nail internal fixation combined with the oral liquid of bone joint and continue to strengthen the bone, and to provide reliable basis for its clinical application. Methods: 40 cases of Sander type II and III calcaneal fractures were randomly divided into two groups: treatment group (n = 20) and control group (n = 20). The treatment group was treated with minimally invasive prying reduction and hollow nail fixation, while the control group was treated with open reduction plate screw fixation. After operation, the two groups were given traditional Chinese medicine (Jiegxujin oral liquid) and combined with functional exercise. The patients were followed up for 612 months after operation. The time of operation, the amount of bleeding, the time of fracture healing, the incidence of postoperative complications and the recovery of function before and after operation were analyzed. The anatomic angle reduction was compared and the evaluation data were analyzed statistically to compare the advantages and disadvantages of the two surgical methods in the treatment of Sander type II and III calcaneal fractures. Results: the two methods obtained satisfactory results in the treatment of Sander type II and III calcaneal fractures. In the functional score, the treatment group and the control group were quite P0.05, while in the imaging anatomical reduction, there was no significant difference between the treatment group and the control group. However, compared with the control group, the treatment group took time and lost blood during the operation. The fracture healing time and the incidence rate of operative complications have obvious advantages (P 0.01). Conclusion: the two methods are effective and reliable in the treatment of Sander type II and III calcaneal fractures. However, compared with open reduction, plate and screw internal fixation, minimally invasive prying reduction and hollow nail internal fixation has the advantages of relatively simple operation, less operation time, less intraoperative bleeding, faster healing, less postoperative complications, and so on. Because of minor surgical trauma, the patient's pain is relatively reduced and the patient is easily accepted. Therefore, minimally invasive prying reduction and hollow nail fixation should be applied as a better method for the treatment of calcaneal fracture under strict indication.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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