结合64排CT三维重建技术手术治疗跟骨骨折的疗效分析

摘要

Objective To treat calcaneal fracture with plate fixation combined with 64-slice CT 3D reconstruction and to analyze the efficacy.Methods Totally 86 patients with Sanders Ⅲ and Ⅳ types of calcaneal fractures underwent surgical treatment,and 64-slice CT 3D reconstruction was used to record the length,height,width,Bohler angle and Gissane angle of calcaneus before and 1 d,2 d,3 d and 1 a after the treatment.Postoperative evaluation was executed based on AOFAS Ankle Hindfoot Scale.Results All the fractures healed,of which,there were 60 ones scored as excellence,19 ones in good condition and 7 ones in satisfactory condition with the excellence and goodness rate being 91.9％.Complications occurred in 4 patients,with 3 cases of delayed healing and one case of infection.Tbere were obviously differences between the lengths,heights,widths,Bohler angles and Gissane angles before and after the treatment,while the differences were not significant between the measured values 1 d and 1 a after the treatment.Conclusion 64-slice CT 3D reconstruction is an excellent clinical auxiliary tool,and is of great value for fracture typing,operational plan preparation,postoperative evaluation and late efficacy assessment.%目的:结合64排CT三维重建技术,使用锁定钢板治疗跟骨骨折,对其治疗效果进行分析.方法:对86例SandersⅢ、Ⅳ型闭合型跟骨骨折采用锁定钢板进行手术治疗,采用64排CT三维重建技术,记录患者术前、术后1～3 d、术后1 a的跟骨长度、高度、宽度及Bohler角、Gissane角的角度.采用美国矫形外科足踝协会评分系统进行术后功能评价.结果:SandersⅢ、Ⅳ型跟骨骨折全部愈合,其中优60足,良19足,中7足,优良率91.9％.术后出现并发症:切口延迟愈合3例,感染1例.术前与术后的跟骨长度、高度、宽度及Bohler角、Gissane角均有改善,差异有统计学意义;术后1d与1 a差异无统计学意义.结论:64排CT的三维重建技术是很好的临床辅助检查方法,对临床骨折分型、制定手术计划、术后评估以及远期的疗效评价都有十分重要的意义.