首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到10条相似文献,搜索用时 125 毫秒
1.
目的探讨经距下关节小切口撬拨复位植骨结合经皮空心钉内固定治疗SandersⅡ、Ⅲ型跟骨关节内骨折的疗效。方法采用跟骨外侧距下关节小切口撬拨复位后植入同种异体骨+经皮空心螺钉内固定治疗35例SandersⅡ、Ⅲ型跟骨骨折患者。测量术前术后Bhler角和Gissane角的变化,根据角度变化数值观察关节面恢复情况。结果 35例均获随访,时间10~32(14±3.5)个月,患者骨折均愈合。未出现切口感染、皮瓣坏死、腓肠神经损伤等并发症。按Maryland足部评分标准评价手术效果:优23例,良9例,可2例,差1例,优良率达91.4%。结论距下关节小切口复位、植骨、经皮空心螺钉内固定治疗SandersⅡ、Ⅲ型跟骨骨折,软组织损伤少、关节面复位好,疗效满意。  相似文献   

2.
切开复位钢板内固定治疗跟骨骨折   总被引:9,自引:3,他引:6  
目的讨论切开复位钢板内固定治疗距下关节移位跟骨骨折的疗效。方法25例30足跟骨骨折病人,其中SandersⅡ型骨折13足,Ⅲ型11足,Ⅳ型6足,切开复位AO钢板固定,必要时自体骨移植治疗。术中侧位C臂监测Bohler角,Broden位观察关节面情况,并于术后、6周、1年分别摄片观测BShler角角度。所有病例随访12~30个月,平均1个月。结果采用AOFAS评分标准评测足部功能,优19足,良7足,可4足,优良率达87%。早期并发症其中切口皮缘坏死3足,腓肠神经损伤2足,远期并发症距下关节创伤性关节炎4例。结论对于合并距下关节损伤的跟骨骨折,治疗的主要目标在于恢复其正常的力学关系,术前评估软组织损伤和骨折类型显得尤其重要,同时尽量减少并发症的发生。  相似文献   

3.
目的 评价开放复位可塑形钛板内固定治疗跟骨骨折的疗效。方法 对33例(37足)以后关节突移位为主的跟骨骨折,行跟骨外侧入路、开放性复位可塑形钛板螺钉内固定,必要时行植骨术(18例)。结果 平均随访11.5个月,参照Mary—land food score评分,对患足是否疼痛、步态、距下关节及踝关节活动度、是否支架辅助、术后X线摄片等加以评估,19足疗效为优,17足为良,1足可。其中钛板断裂1例,手术切口皮缘坏死1例,换药后自愈。结论 跟骨外侧入路开放复位可塑形钛板螺钉内固定,必要时植骨术是治疗跟骨骨折的有效方法。  相似文献   

4.
背景:手术治疗是跟骨关节内骨折有效的治疗方法,如何减少手术创伤,提高手术疗效,是临床研究的难题。目的:探讨小切口复位植骨空心钉内固定治疗部分跟骨关节内骨折的短期疗效。方法:2006年1月至2010年1月,对27例(32足)部分塌陷移位的跟骨关节内骨折(Sanders分型为Ⅱ~Ⅲ型)采用距下关节外侧小切口入路、复位距下关节面、同种异体骨移植,中空钉内固定进行治疗。术后患者均石膏托外固定4周。结果:所有患者术后获得6~48个月(平均22.9个月)随访,骨折全部愈合。按Maryland足部评分标准评价手术效果:优22足,良7足,可3足,优良率91%。无一例发生切口皮缘坏死及螺钉断裂。结论:有移位的Ⅱ、Ⅲ型跟骨关节内骨折,采用小切口切开复位植骨空心钉内固定治疗可获得满意疗效,能避免切口缘浅表坏死等并发症的发生,短期疗效可靠。  相似文献   

5.
Fractures of the tuberosity of the calcaneus   总被引:5,自引:0,他引:5  
We describe 24 fractures of the tuberosity of the calcaneus in 22 patients. Three were similar to the type of avulsion fracture which has been well-defined but the remainder represent a group which has been unrecognised previously. Using CT and operative findings we have defined the different patterns of fracture of the calcaneal tuberosity. Ten fractures extended into the subtalar joint, but did not fit the pattern of the common intra-articular fracture as described classically. We have defined a new pattern which consists of a fracture of the medial calcaneal process with a further fracture which separates the upper part of the tuberosity in the semicoronal plane. Non-operative treatment of displaced fractures resulted in a mis-shapen heel and a poor functional outcome. Open reduction and internal fixation with either a plate or compression screw did not give satisfactory fixation. We prefer to use an oblique lateral tension-band wire. This technique gave excellent fixation and we recommend it for the treatment of displaced fractures of the tuberosity of the calcaneus.  相似文献   

6.
Y形钢板治疗跟骨关节内骨折分析   总被引:4,自引:1,他引:3  
[目的]分析使用开放复位Y形钢板内固定治疗跟骨关节内骨折的治疗方法和疗效。[方法]自2002年3月-2004年12月,对38例43足累及距下关节的跟骨骨折行开放复位Y形钢板内固定治疗。[结果]36例4l足获随访6个月-3a(平均20个月),按Maryland足部评分系统评价术后功能,优16足,良22足,优良率为93%。[结论]开放复位Y形钢板内固定能使骨折解剖复位,病人能早期进行功能锻炼,是治疗跟骨关节内骨折较好的方法。  相似文献   

7.
The ideal treatment of displaced intra-articular calcaneal fractures is still controversially discussed. Because of the variable fracture patterns and the vulnerable soft tissue coverage an individual treatment concept is advisable. In order to minimize wound edge necrosis associated with extended lateral approaches, selected fractures may be treated percutaneously or in a less invasive manner while controlling joint reduction via a sinus tarsi approach. Fixation in these cases is achieved with screws, intramedullary locking nails or modified plates that are slid in subcutaneously. A thorough knowledge of the three dimensional calcaneal anatomy and open reduction maneuvers is a prerequisite for good results with less invasive techniques. Early functional follow-up treatment aims at early rehabilitation independent of the kind of fixation. Peripheral fractures of the talus and calcaneus frequently result from subluxation and dislocation at the subtalar and Chopart joints. They are still regularly overlooked and result in painful arthritis if left untreated. If an exact anatomical reduction of these intra-articular fractures is impossible, resection of small fragments is indicated.  相似文献   

8.
The ideal treatment of displaced intra-articular calcaneal fractures is still controversially discussed. Because of the variable fracture patterns and the vulnerable soft tissue coverage an individual treatment concept is advisable. In order to minimize wound edge necrosis associated with extended lateral approaches, selected fractures may be treated percutaneously or in a less invasive manner while controlling joint reduction via a sinus tarsi approach. Fixation in these cases is achieved with screws, intramedullary locking nails or modified plates that are slid in subcutaneously. A thorough knowledge of the three dimensional calcaneal anatomy and open reduction maneuvers is a prerequisite for good results with less invasive techniques. Early functional follow-up treatment aims at early rehabilitation independent of the kind of fixation. Peripheral fractures of the talus and calcaneus frequently result from subluxation and dislocation at the subtalar and Chopart joints. They are still regularly overlooked and result in painful arthritis if left untreated. If an exact anatomical reduction of these intra-articular fractures is impossible, resection of small fragments is indicated.  相似文献   

9.
切开复位内固定治疗跟骨关节内骨折   总被引:7,自引:1,他引:6  
目的 探讨切开复位内固定治疗跟骨关节内骨折的临床疗效。方法 跟骨外侧L形切口显露跟骨,按后关节面和距下关节→Boehler角和Gissane角→跟骨的长度,宽度和高度的顺序整复跟骨关节内骨折和邻近关节;并用可塑型跟骨钛钢板内固定治疗跟骨关节内骨折共35例,38例,其中Sander'sⅡ型8侧,Ⅲ型14侧,Ⅳ型16侧。结果 术后X线片显示骨折愈合时间为5-12周(平均7.1周);33侧术后获6-22个月(平均12.3个月)随访,按Maryland足部评分系统评价术后功能,其中优18侧,良13侧,可2侧,优良率为93.9%。结论 切开复位和可塑型跟骨钛钢板内固定治疗跟骨关节内骨折可获得满意的临床疗效。  相似文献   

10.
The treatment of displaced fractures of the talus and calcaneus is associated with a considerable learning curve. Malunion results in significant limitations of global foot function and painful posttraumatic arthritis. While early reduction of dislocations and fracture dislocations represent an emergency situation, the timing of definitive fixation has no measurable impact on the results and the incidence of avascular necrosis in central fractures of the talus. For internal fixation of displaced fractures with central comminution or medial joint impaction, anatomically shaped interlocking plates are available in addition to screws. The ideal treatment of displaced intra-articular calcaneal fractures is still controversial. Because of the variable fracture patterns and the vulnerable soft tissue cover, an individual treatment concept is advisable. In order to minimize the wound margin necrosis associated with extensile lateral approaches, selected fractures should be treated with less invasive fixation while controlling joint reduction via a sinus tarsi approach. Fixation in these cases is achieved with screws, intramedullary locking nails or modified plates that are inserted subcutaneously. Displaced extra-articular and simple intra-articular fractures can be reduced and fixed percutaneously. Functional aftertreatment aims at early rehabilitation independent of the kind of fixation. Peripheral fractures of the talus and calcaneus frequently result from subluxation and dislocation at the subtalar and Chopart's joints. They are still regularly overlooked and result in painful arthritis if left untreated. If an exact anatomical reduction of these intra-articular fractures is impossible, resection of small fragments is indicated.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号