钢针经皮撬拨复位与开放复位钢板内固定治疗 SandersⅢ～Ⅳ型跟骨骨折疗效比较

摘要

目的：比较钢针经皮撬拨复位内固定和开放复位钢板内固定治疗SandersⅢ～Ⅳ型跟骨骨折的疗效。方法分析我院2007年12月-2012年12月收治SandersⅢ～Ⅳ型跟骨骨折30例，分别接受钢针经皮撬拨复位内固定15例（撬拨组），开放复位钢板内固定15例（切开组），观察2组的疗效及手术前后相关角度复位情况并进行比较。结果本组30例患者均获得随访，随访6月～54个月（平均18．5个月），按照Maryland足部评分系统评价术后功能，切开组明显优于撬拨组。表现在Bohler角、Gissane角和足部功能的恢复具有显著性差异（P＜0．05）。结论开放复位钢板内固定能更好地恢复跟骨的解剖结构，如能较好掌握手术适应症，精细操作，开放复位内固定不失为一种治疗SandersⅢ～Ⅳ型跟骨骨折的更好方法。%Objective To explore the clinical effect between percutaneous poking fixation with kirschner wire and open re -duction internal fixation ( ORIF) with plate in treatment of Sanders Ⅲ~Ⅳcalcaneal fracture .Methods The operation and fol-low-up data of 30 cases of Sanders Ⅲ~Ⅳcalcaneal fracture between December 2007 and December 2012 were retrospectively analyzed.30 patients with calcaneal fracture were divided into two groups , who were treated with percutaneous poking fixation and ORIF respectively and were compared as for their healing effects and operation indexes .Results All the 30 cases were followed up for 6~54 months (average18.5 months).According to Maryland foot scores , the rates of excellent and good of the two groups were 60.0%and 93.3%respectively.Open reduction group was significantly better than percutaneous poking fixa-tion group.There was significant difference on the recovery of foot function (P<0.05),Bohler angle(P<0.01),and Gissane angle(P<0.05).Conclusion ORIF has a better clinical effect.It is a more applicable surgery for treating SandersⅢ~Ⅳcalcaneal fracture .