地震病人跟骨骨折的手术治疗
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摘要
[目的]探讨地震伤员跟骨骨折的特点及切开复位内固定治疗临床效果。[方法]骨折采用Sanders分型,15例24侧采用切开复位内固定治疗,有13例21侧获得4～4.5个月随访,平均随访时间4.2个月。[结果]所有骨折均愈合。按Maryland足部评分系统评价,本组优9侧(42.9%),良10侧(47.6%),可2侧(9.5%),优良率90.5%。伤口感染2侧经皮瓣转移后治愈。[结论]切开复位内固定是治疗跟骨关节内移位骨折的有效方法。地震伤员不宜过早手术,应待病人身体各项指标基本正常、心理情况稳定后手术。
[Objective]To investigate the characteristics and clinical results of open reduction and internal fixation for fractures of the calcaneus for earthquake patients.[Method]The fractures were classified according to Sanders classification.Fifteen cases(24 fractures) were treated by open reduction and internal fixation.Thirteen cases(21 fractures) were followed up from four,four and half months(average of 4.2 months).[Result]All fractures had been healed.Functional results were evaluated using Marryland Foot Score and excellent results occured in 9(42.9%),good in 10(47.6%),fair in 2(9.5%) and the satisfactory rate was 90.5%.Two cases of incision infection were cured by skin flap transplantation.[Conclusion]Open reduction and internal fixation is an effective method for treatment of displaced intra-articular fractures of the calcaneus.Earthquake patients are not fit for early operation.They should be treated with operation after normal functional index and stable psychological situation.
[Objective]To investigate the characteristics and clinical results of open reduction and internal fixation for fractures of the calcaneus for earthquake patients.[Method]The fractures were classified according to Sanders classification.Fifteen cases(24 fractures) were treated by open reduction and internal fixation.Thirteen cases(21 fractures) were followed up from four,four and half months(average of 4.2 months).[Result]All fractures had been healed.Functional results were evaluated using Marryland Foot Score and excellent results occured in 9(42.9%),good in 10(47.6%),fair in 2(9.5%) and the satisfactory rate was 90.5%.Two cases of incision infection were cured by skin flap transplantation.[Conclusion]Open reduction and internal fixation is an effective method for treatment of displaced intra-articular fractures of the calcaneus.Earthquake patients are not fit for early operation.They should be treated with operation after normal functional index and stable psychological situation.
引文
[1]Gustilo RB,Mendoza RM,Williams DN.Problems in the managementof typeⅢ(severe)open fractures:a new classification of typeⅢopen fractures[J].J Trauma,1984,24:742-746.
[2]Sanders R,Fortin P,Dipasquale T,et al.Operative treatment in 120displaced intraarticular calcaneal fractures.Results using a prognosticcomputed tomography scan classification[J].Clin Orthop,1993,290:87-95.
[3]B hler L.Diagnosis,pathology and treatment of fractures of the oscal-cis[J].J Bone Joint Surg,1931,13:75-89.
[4]Parmar HV,Triffitt PD,Gregg PJ.Intra-articular fractures of the cal-caneum treated operatively or conservatively.Aprospective study[J].J Bone Joint Surg(Br),1993,75:932-937.
[5]梅炯,俞光荣,朱辉,等.SandersⅣ型跟骨骨折的手术治疗[J].中华外科杂志,2001,39:106-108.
[6]倪明,梅炯,俞秀茂,等.经皮撬拨复位内固定联合替代骨填充治疗跟骨关节内骨折[J].中国矫形外科杂志,2008,6:401-404.
[7]Aldridge JM3rd,Easley M,Nunley JA.Open calcaneal fractures:re-sults of operative treatment[J].J Orthop Trauma,2004,18:7-11.
[8]梅炯,俞光荣,朱辉,等.跟骨载距突的解剖特点及其临床意义[J].中国临床解剖杂志,2002,20:91.
[9]Csizy M,Buckley R,Tough S,et al.Displaced intra-articular calcane-al fractures:variables predicting late subtalar fusion[J].J OrthopTrauma,2003,17:106-112.
[2]Sanders R,Fortin P,Dipasquale T,et al.Operative treatment in 120displaced intraarticular calcaneal fractures.Results using a prognosticcomputed tomography scan classification[J].Clin Orthop,1993,290:87-95.
[3]B hler L.Diagnosis,pathology and treatment of fractures of the oscal-cis[J].J Bone Joint Surg,1931,13:75-89.
[4]Parmar HV,Triffitt PD,Gregg PJ.Intra-articular fractures of the cal-caneum treated operatively or conservatively.Aprospective study[J].J Bone Joint Surg(Br),1993,75:932-937.
[5]梅炯,俞光荣,朱辉,等.SandersⅣ型跟骨骨折的手术治疗[J].中华外科杂志,2001,39:106-108.
[6]倪明,梅炯,俞秀茂,等.经皮撬拨复位内固定联合替代骨填充治疗跟骨关节内骨折[J].中国矫形外科杂志,2008,6:401-404.
[7]Aldridge JM3rd,Easley M,Nunley JA.Open calcaneal fractures:re-sults of operative treatment[J].J Orthop Trauma,2004,18:7-11.
[8]梅炯,俞光荣,朱辉,等.跟骨载距突的解剖特点及其临床意义[J].中国临床解剖杂志,2002,20:91.
[9]Csizy M,Buckley R,Tough S,et al.Displaced intra-articular calcane-al fractures:variables predicting late subtalar fusion[J].J OrthopTrauma,2003,17:106-112.
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