| 黄冠予,彭昊.微创空心螺钉治疗跟骨骨折25例疗效分析[J].安徽医药,2018,22(7):1268-1272. |
| 微创空心螺钉治疗跟骨骨折25例疗效分析 |
| Treatment of 25 cases of calcaneal fracture with minimally invasive cannulated screw |
| 投稿时间：2017-03-16 |
| DOI： |
| 中文关键词: 跟骨 骨折 骨钉 外科手术, 微创性 骨折固定术, 内 治疗结果 |
| 英文关键词: Calcaneus Fractures, bone Bone nails Surgical procedures, minimally invasive Fracture fixation, internal Treatment outcome |
| 基金项目:国家自然基金项目(81672154) |
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| 中文摘要: |
| 目的 探讨微创空心螺钉治疗跟骨骨折的治疗效果与可行性。方法 回顾性分析2013年7月至2014年7月间的47例跟骨骨折患者,男35例,女12例,年龄(33.9±6.3)岁。切开复位内固定术组22例,男17例,女5例,Sanders分型:Ⅱ型16例,Ⅲ型4例,Ⅳ型2例。微创空心钉组25例,男18例,女7例,Sanders分型:Ⅱ型22例,Ⅲ型2例,Ⅳ型1例。对比分析两组患者的Maryland评分、术后并发症、手术花费、住院日、手术时间、生化指标(TRACP 5b 和 CTX)及Bolher角和Gissane角的恢复情况。结果 所有患者均获得6个月的随访,微创空心钉组患者住院日[(9.5±1.2) d,t=5.666,P<0.001)]、手术花费[(12 310.6±824.8)元,t=8.662,P< 0.001]及手术时间[(74.1±10.8) min,t=4.374,P<0.001]与切开复位组[(12.1±1.79) d；(15 287.4±1 414.2)元；(87.6±10.2) min]相比差异有统计学意义(P<0.05),两组患者术后Maryland评分优良率(77.27%比84.00%,χ2=0.342,P=0.715)、术后并发症(P=0.593)、抗酒石酸酸性磷酸酶5 b[(3.53±0.29) U·L-1比(3.56±0.30) U·L-1,t=0.347,P=0.730]、Ⅰ型胶原蛋白羧基端肽[(553.88±32.14) μg·L-1 比(556.11±16.80) μg·L-1,t=0.291,P=0.772]及Bolher角(29.84°±1.83°比29.91°±1.91°,t=0.127,P=0.899)和Gissane角(132.85°±5.41°比134.37°±4.92°,t=1.008,P=0.318)的恢复情况比较,差异无统计学意义(P>0.05)。结论 对于Sanders Ⅱ型及Sanders Ⅲ型骨折,微创空心螺钉与传统术式疗效相当,且具有操作简便、经济、创伤较小、耗时较短等优点。 |
| 英文摘要: |
| Objective To investigate the effect and the viability of minimally invasive for calcaneal fractures with cannulated screw fixation. Methods We selected a total of 47 calcaneal fracture patients (35 males and 12 females, average age 33.9±6.3 years old) from July 2013 to July 2014. According to Sanders classification, in the plate fixation group (17 males and 5 females), 16 cases belong to typeⅡ, 4 cases belong to type Ⅲ, 2 cases belong to type Ⅳ. In the cannulated screw fixation group(18 males and 7 females), 22 cases belong to typeⅡ, 2 cases belong to type Ⅲ, 1 cases belong to type Ⅳ. We compare and retrospective analysis about the therapeutic outcomes, post-operation complications, cost effectiveness, operative time, the level of TRACP 5b and CTX, Bolher angle and Gissane angle of these patients. Results All case were follow-up for 6 months. The hospital stay(9.5±1.2 d,t=5.666,P<0.001),surgery cost(12 310.6± 824.2 RMB,t=8.662,P<0.001)and operative time(74.1±10.8 min,t=4.374,P<0.001) in cannulated screw fixation group are better than the plate fixation group(12.1±1.8 d；15 287.4±1 414.2 RMB；87.6±10.2 min；P<0.05). However, in therapeutic outcomes(77.27% vs. 84.00%,χ2=0.342,P=0.715), post-operation complications(P=0.593), the level of TRACP 5b (3.53±0.29U·L-1 vs. 3.56±0.30 U·L-1,t=0.347,P=0.730)and CTX(553.88±32.14μg·L-1vs. 556.11±16.80μg·L-1,t=0.291,P=0.772), Bolher angle(29.84°±1.83°vs. 29.91°±1.91°,t=0.127,P=0.899)and Gissane angle(132.85°±5.41° vs. 134.37°±4.92°,t=1.008,P=0.318), there are no significant difference between the cannulated screw fixation group and the plate fixation group(P>0.05). Conclusions For the Sanders Ⅱ and Ⅲ pattern calcaneal fractures, minimally invasive for calcaneal fractures with cannulated screw fixation is a simple and high cost effectiveness method of the calcaneal fracture treatment and has equality therapeutic effect contrast to the plate fixation. |
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