经皮撬拨复位克氏针内固定治疗Sanders2型跟骨舌形骨折

目的:观察经皮撬拨复位克氏针内固定治疗Sanders 2型跟骨舌形骨折的疗效,探讨Sanders 2型跟骨舌形骨折的治疗方案。方法:15例Sanders 2型跟骨舌形骨折患者,采用经皮撬拨复位克氏针内固定治疗,要求后跟距关节面解剖复位,恢复跟骨的长宽高度和Bhler角、Gissane角。术后2年内每月随访1次,根据AOFAS评分标准对患者的术后功能作出评价,并结合X片测量Bhler角及Gissane角,分析比较手术前后两角度的变化。结果:15例全部完成随访。术前Bhler角平均(8.2±1.3)度,术后平均(34.5±2.6)度,差异有高度显著意义(P<0.01);术前Gissane角(107.5±4.8)度,术后平均(116.3±5.1)度,差异有高度显著意义(P<0.01)。术后2年的AOFAS评分平均82.6分。结论:经皮撬拨复位克氏针内固定治疗Sanders 2型跟骨舌形骨折具有关节面复位准确、疗效可靠及创伤小等优点,但必须正视该方法的缺陷。

Percutaneous reduction for Sanders type 2 tongue fracture of calcaneus using leverage and pin internal fixation

Objective: To observe the therapeutic effect of percutaneous reduction for Sanders type 2 tongue fracture of calcaneus using leverage and pin internal fixation and study the treatment of Sanders type 2 tongue fracture of calcaneus.Methods: Fifteen cases of Sanders type 2 tongue fracture of the calcaneus were treated with percutaneous reduction by leverage and pin internal fixation.The goal of orthopedics was to get anatomic reduction of the facet of talus and calcaneus,to recover Bhler angle,Gissane angle,the height,width and length of the calcanues.Based on the American Orthopaedic Foot and Ankle Society(AOFAS) scale,the patients were evaluated every month in 2 years after the operation for the functions.Changes of Bhler angle and Gissane angle before and after operation were compared according to the measurement of X-ray film of them.Results: Follow-up of the15 cases was valid.The Bhler angle changed from(8.2±1.3) degree to(34.5±2.6) degree,and the Gissane angle changed from(107.5±4.8) degree to(116.3±5.1) degree;there were significant differences between before and after operation(P<0.01).The mean of AOFAS scale in 2 years after the operation was 82.6 points.Conclusion: Percutaneous reduction for Sanders type 2 tongue fracture of the calcaneus using leverage and pin internal fixation has advantages of accurate articular facet reduction,high reliable effect and less injury;but its drawback must alert.