两种方法治疗SandersⅡ型跟骨骨折的疗效比较

目的评价撬拨复位与切开复位治疗成人SandersⅡ型跟骨骨折的疗效。方法回顾性分析2006年10月至2010年10月我院采用上述两种方法治疗的SandersⅡ型跟骨骨折患者共52例,成功随访36例,其中撬拨19例,切开复位17例。术后跟踪调查,X线影像学指标评价骨折愈合情况,Maryland足功能评分系统评价患者治疗后1年的足部功能恢复情况,统计分析术后并发症。结果术后随访36例,平均随访12个月,随访率69.23%,X线示两组患者骨折均愈合。撬拨组与切复组在足部功能评分、影像学评价方面比较差异无统计学意义（P〉0.05）。并发症综合分析上,切口裂开之并发症,撬拨组较切复组有明显优势（P〈0.05）,余并发症两组差异无统计学意义（P〉0.05）。结论撬拨复位术治疗SandersⅡ型跟骨骨折明显优于切开复位内固定术,前者创伤小,简便易行,并发症少,可作为该型跟骨骨折治疗首选。

Comparative study on two methods for the treatment of type Sanders Ⅱ calcaneal fractures

Objective To evaluate the effect between percutaneous poking fixation and open reduction internal fixation in the treatment of adult Sanders Ⅱfractures of calcaneus. Meth- ods Retrospective analysis of our hospital using these two methods in treatment of adult Sanders 11 fractures of calcaneus in 52 cases from October 2006 to October 2010, successful follow up in 36 cases, repositioning of 19 cases, open reduction of 17 cases. Postoperative follow-up was taken, X-ray imaging was used to evaluate fracture healing, patient＇s foot function after 1 year was evaluated by Maryland assessment scoring system, and postoperative complications were sta- tistically analyzed. Results A total of 36 cases patients were postoperatively followed up, with the mean follow-up time was 12 months, the rate of follow-up was 69.23~, fracture of two groups patients was healed which was showed by X-ray. The comparative differences of foot function and imaging evaluation between repositioning group and cutting compound group was not statistical（P〈0.05）. On the integrated analysis of complications, poking group had more clear advantage than cutting compound group（P〈0.05）. Two sets of differences in the remaining complications was not statistical（P〈0.05）. Conclusion Poking reduction for treatment of San-ders Ⅱ fracture of calcaneus is much better than the open reduction and internal fixation. The former has little trauma, simple and easy, and fewer complications, it can be used as the pre-ferred treatment of the type of calcaneal fractures.