[1]黄高,张军,水小龙,等.经皮闭合复位内固定与外侧“L”形切口切开复位内固定 治疗SandersⅡ型跟骨骨折的比较研究[J].中医正骨,2013,25(04):18-22.
　HUANG Gao*,ZHANG Jun,SHUI Xiao-long,et al.A prospective,randomized,controlled trial of closed reduction and percutaneous fixation versus open reduction and internal fixation through lateral L-shape incision for treatment of Sanders typeⅡcalcaneus fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(04):18-22.
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经皮闭合复位内固定与外侧“L”形切口切开复位内固定 治疗SandersⅡ型跟骨骨折的比较研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期数:
2013年04期
页码:
18-22
栏目:
足踝损伤
出版日期:
2013-04-30

文章信息/Info

Title:
A prospective,randomized,controlled trial of closed reduction and percutaneous fixation versus open reduction and internal fixation through lateral L-shape incision for treatment of Sanders typeⅡcalcaneus fractures
作者:
黄高; 张军; 水小龙; 孔建中
温州医学院附属第二医院,浙江 温州 325027
Author(s):
HUANG Gao*; ZHANG Jun; SHUI Xiao-long; KONG Jian-zhong.*
The Second Affiliated Hospital of Wenzhou Medical College,Wenzhou 325027,Zhejiang,China
关键词:
骨折 跟骨 骨折固定术; 内 外科手术; 微创性
Keywords:
Fractures; bone;  Calcaneus;  Fracture fixation; internal;  Surgical procedures; minimally invasive
摘要:
目的:比较经皮闭合复位内固定与外侧“L”形切口切开复位内固定治疗SandersⅡ型跟骨骨折的一般情况、临床疗效和安全性。方法:将纳入研究的40例SandersⅡ型跟骨骨折患者随机分为2组,每组20例。A组采用经皮闭合复位内固定治疗,B组采用外侧“L”形切口切开复位内固定治疗。记录患者的手术时间、住院时间及治疗费用,术后3个月随访时采用Maryland足部功能评分标准评定患者的足部功能,同时记录术后患者发生感染、骨折不愈合及内固定失败等并发症的发生情况。结果:①一般情况。A组患者的手术时间、住院时间及治疗费用均少于B组[(35.50±3.46)min,(74.20±5.40)min,t=-24.186,P=0.001;(3.85±0.75)d,(10.15±4.40)d,t=40.120,P=0.001;(9 673.70±391.99)元,(15 740.00±530.69)元,t=-6.414,P=0.001]。②临床疗效。按照Maryland足部功能评分标准,A组优17例,良3例; B组优14例,良6例。2组患者足部功能比较,差异无统计学意义(U=170.000,P=0.262)。③安全性。术后B组4例患者发生切口感染,经换药后痊愈。2组均未出现骨折不愈合及内固定失败的病例。2组患者并发症发生率比较,差异无统计学意义(P=0.106)。结论:经皮闭合复位内固定和外侧“L”形切口切开复位内固定治疗SandersⅡ型跟骨骨折的疗效及安全性相当,但前者具有手术时间和住院时间短、治疗费用低的优势。
Abstract:
Objective:To compare the general conditions,clinical curative effects and safety between the therapy of closed reduction and percutaneous fixation and the therapy of open reduction and internal fixation through lateral L-shape incision for treatment of Sanders typeⅡcalcaneus fractures.Methods:Forty patients with Sanders typeⅡcalcaneus fractures were included into the study and were divided into 2 groups,20 cases in each group.Patients in group A were administrated with closed reduction and percutaneous fixation,while the others in group B were administrated with open reduction and internal fixation through lateral L-shape incision.The operative time,hospital stay and hospitalization costs of patients were recorded.Patients were followed up and the foot function were evaluated according to Maryland foot performance scores 3 months after operation,meanwhile,such postoperative complications as infection,nonunion and internal fixation failure were recorded.Results:The operative time,hospital stay and hospitalization costs of group A were all lower than those of group B[(35.50±3.46)min vs(74.20±5.40)min,t=-24.186,P=0.001;(3.85±0.75)d vs(10.15±4.40)d,t=40.120,P=0.001;(9 673.70±391.99)yuan vs(15 740.00±530.69)yuan,t=-6.414,P=0.001].According to Maryland foot performance scores,17 patients obtained an excellent result and 3 fair in group A; while 14 patients obtained an excellent result and 6 fair in group B.There was no statistical difference in foot function between the 2 groups(U=170.000,P=0.262).Four patients with incision infection were found in group B and they were all healed through dressing change.No cases with nonunion and internal fixation failure were found in the 2 groups.There was no statistical difference in the incidence rate of complications between the 2 groups(P=0.106).Conclusion:The therapy of closed reduction and percutaneous fixation is similar to the therapy of open reduction and internal fixation through lateral L-shape incision in the curative effect and safety for Sanders typeⅡcalcaneus fractures,while the former has such advantages as shorter operative time,shorter hospital stay and lower hospitalization costs.

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备注/Memo

备注/Memo:
2012-06-06收稿 2012-09-15修回
通讯作者:孔建中 E-mail:jzkongfey@126.com
更新日期/Last Update: 2013-04-30