斯氏针撬拨闭合复位轴向结合横向多枚中空钉内固定修复跟骨骨折

摘要

BACKGROUND:The treatment of calcaneal fractures using open surgery is likely to cause greater trauma. OBJECTIVE:To explore the clinical effect of steinmann pin poking closed reduction axial combined with lateral multiple hol ow screws internal fixation in repair of Sanders II, III type calcaneal fractures. METHODS:The clinical data of 73 patients with Sanders II, III type calcaneal fractures were retrospectively analyzed and divided into conventional group (n=36) and experimental group (n=37) according to the treatment method. Patients in these two groups were respectively treated with conventional open reduction internal fixation and steinmann pin poking closed reduction axial combined with lateral multiple hol ow screws internal fixation. RESULTS AND CONCLUSION:Compared with the conventional group, the hospital stays of patients in experimental group were shorter, hospital costs reduced. There were no obvious changes in the foot rating from the American Association of Ankle Injuries, Böhler angle and Gissane angle. The incidence of complications was significantly decreased. These results demonstrate that the treatment of Sanders II, III type calcaneal fractures with conventional open reduction and bone plate internal fixation and steinmann pin poking closed reduction axial combined with lateral multiple hol ow screws internal fixation can obtain the basic equivalent clinical effect, however, the treatment of steinmann pin poking closed reduction axial combined with lateral multiple hol ow screws internal fixation have more obvious advantages, such as a shorter hospital stays, less hospital costs, and also can effectively control the complications.%背景：采用开放性手术治疗跟骨骨折，容易造成较大的创伤。　　目的：探索斯氏针撬拨闭合复位轴向结合横向多枚中空钉内固定治疗Sanders Ⅱ、Ⅲ型跟骨骨折的临床效果。方法：回顾性分析73例Sanders Ⅱ、Ⅲ型跟骨骨折患者的临床资料，按照治疗方法分为常规组(n=36)和实验组(n=37)，分别实施常规切开复位内固定治疗和斯氏针撬拨闭合复位轴向结合横向多枚中空钉内固定治疗。结果与结论：与常规组相比，实验组患者住院天数缩短，住院费用降低，美国足踝创伤协会之足部评分、Böhler角和Gissane角无明显变化，并发症发生率明显下降。表明对Sanders Ⅱ、Ⅲ型跟骨骨折患者实施常规切开复位跟骨板内固定治疗和斯氏针撬拨闭合复位轴向结合横向多枚中空钉内固定治疗可以获得基本相当的临床效果，而斯氏针撬拨闭合复位轴向结合横向多枚中空钉内固定治疗具有住院时间更短、费用更低的明显优势，同时也能有效控制并发症发生。