经皮微创撬拨复位内固定手术治疗跟骨骨折

目的探讨经皮微创撬拨复位内固定手术治疗跟骨骨折的疗效。方法应用经皮撬拨复位＋螺钉内固定治疗SandersⅡ、Ⅲ型跟骨骨折13例（14足）。术中侧位透视观察Bhler和Gissane角,Broden位观察后关节面的复位情况。围手术期常规应用抗生素防止感染。结果13例均获随访,时间3～12（5.6±2.0）个月。骨折愈合时间2.5～3.2（2.8±0.3）个月。按Maryland足部评分系统：优9足,良4足,中1足。未发生皮缘坏死、伤口感染及腓肠神经损伤等并发症。结论经皮撬拨复位＋螺钉内固定技术,适用于骨折粉碎程度较轻,塌陷不严重的跟骨骨折,尤其是SandersⅡ型。具有术后伤口恢复快、并发症少的优点。

Minimally invasive treatment of calcaneal fractures by percutaneous reduction and osteosynthesis technique

Objective To investigate the therapeutic effect of minimally invasive treatment of calcaneal fractures by percutaneous reduction and osteosynthesis technique. Methods 14 sides of sanders type Ⅱ , Ⅲ calcaneal fractures in 13 patients were treated with percutaneous minimally invasive reduction and screw fixation. Among them, 11 sides were belong to Sanders type Ⅱ ,3 to Sanders type Ⅲ. All of them were assessed Bohler and Gissane angle in lateral view under fluoroscopic guidance, and the congruency of the posterior facet in Broden view during operation. Prophylactic antibiotics were used. Results The mean follow-up period was 5.6±2.0 months （ range from 3 to 12 months） for 13 cases. The fractures were healed at 2. 5-3. 2（2. 8 ±0. 3） months. All the patients were evaluated by Maryland foot score. The score was excellent in 9 feet, good in 4, and fair in 1. No complication such as flap necrosis, wound infection or sural nerve injury was found. Conclusions Percutaneous minimally invasive reduction and screw fixation technique is a useful method to treat calcaneal fractures with less severe comminuted blocks and less compressive degree cases, especially for Sanders types Ⅱ cases, with rapid wound healing and less complications.