跟骨骨折经皮撬拨术后张力带夹板固定疗效观察

目的：观察经皮撬拨张力带夹板固定治疗跟骨骨折的临床疗效。方法：2007年9月至2009年2月，采用经皮撬拨复位方法治疗40例42足跟骨骨折，男28足，女14足；年龄18～55岁，平均34.2岁。病程2 h～7 d,均为新鲜闭合性跟骨关节内骨折。按术后固定方式分为两组，石膏固定组20足，张力带夹板固定组22足。术后参照美国足踝骨科协会足踝临床评分从跟骨宽度的恢复、功能康复、并发症3个方面进行比较分析。结果：40例患者皆获随访，时间为6个月～2年，平均9个月。跟骨宽度恢复、功能恢复、对线情况，张力带夹板固定组均优于石膏固定组(P<0.05);疼痛情况两组差异无统计学意义(P>0.05).两种固定后期并发症发生，张力带夹板组明显低于石膏固定组(P<0.05).结论：张力带夹板固定治疗跟骨骨折具有稳定跟骨宽度、并发症少等优点。

Clinical efftect of percutaneous poking and tension band splint fixation for treatment of the calcaneal fracture

Objective: To observe the clinical efficacy of percutaneous poking tension band splint fixation for the treatment of calcaneal fractures. Methods: From September 2007 to February 2009,40 patients with calcaneal fractures(42 feet) were treated by percutaneous poking reduction,including 28 feet of male and 14 feet of female,with an average age of 34.2 years ranging from 18 to 55 years. The course was from 2 hours to 7 days. All fractures were fresh and closed intra-articular calcaneal fractures. Patients were divided into two groups according to fixation methods,plaster fixation in 20 feet,tension band splint in 22 feet. Three aspects including the heel of the foot and ankle width of recovery,functional recovery,complications were compared according to the United States Orthopedic Foot and Ankle Society clinical score. Results: These 40 patients were followed-up for 6 months to 2 years with an average of 9 months. The calcaneal width of the recovery,the functional recovery and force line of tension band splint group were all better than that of plaster fixation group (P<0.05);There were no significant differences in pain between two groups(P>0.05). Occurrence of complications in tension band splint group were lower than that of plaster fixation group(P<0.05). Conclusion: Percutaneous poking tension band splint have adevantage of stable calcaneal width and fewer complications on treatment of calcaneal fractures.