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[1]黃高,張軍,水小龍,等.經(jīng)皮閉合復(fù)位內(nèi)固定與外側(cè)“L”形切口切開復(fù)位內(nèi)固定 治療SandersⅡ型跟骨骨折的比較研究[J].中醫(yī)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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經(jīng)皮閉合復(fù)位內(nèi)固定與外側(cè)“L”形切口切開復(fù)位內(nèi)固定 治療SandersⅡ型跟骨骨折的比較研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期數(shù):
2013年04期
頁碼:
18-22
欄目:
足踝損傷
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:
黃高; 張軍; 水小龍; 孔建中
溫州醫(yī)學(xué)院附屬第二醫(yī)院,浙江 溫州 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
關(guān)鍵詞:
骨折 跟骨 骨折固定術(shù); 內(nèi) 外科手術(shù); 微創(chuàng)性
Keywords:
Fractures; bone;  Calcaneus;  Fracture fixation; internal;  Surgical procedures; minimally invasive
摘要:
目的:比較經(jīng)皮閉合復(fù)位內(nèi)固定與外側(cè)“L”形切口切開復(fù)位內(nèi)固定治療SandersⅡ型跟骨骨折的一般情況、臨床療效和安全性。方法:將納入研究的40例SandersⅡ型跟骨骨折患者隨機分為2組,每組20例。A組采用經(jīng)皮閉合復(fù)位內(nèi)固定治療,B組采用外側(cè)“L”形切口切開復(fù)位內(nèi)固定治療。記錄患者的手術(shù)時間、住院時間及治療費用,術(shù)后3個月隨訪時采用Maryland足部功能評分標(biāo)準(zhǔn)評定患者的足部功能,同時記錄術(shù)后患者發(fā)生感染、骨折不愈合及內(nèi)固定失敗等并發(fā)癥的發(fā)生情況。結(jié)果:①一般情況。A組患者的手術(shù)時間、住院時間及治療費用均少于B組[(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臨床療效。按照Maryland足部功能評分標(biāo)準(zhǔn),A組優(yōu)17例,良3例; B組優(yōu)14例,良6例。2組患者足部功能比較,差異無統(tǒng)計學(xué)意義(U=170.000,P=0.262)。③安全性。術(shù)后B組4例患者發(fā)生切口感染,經(jīng)換藥后痊愈。2組均未出現(xiàn)骨折不愈合及內(nèi)固定失敗的病例。2組患者并發(fā)癥發(fā)生率比較,差異無統(tǒng)計學(xué)意義(P=0.106)。結(jié)論:經(jīng)皮閉合復(fù)位內(nèi)固定和外側(cè)“L”形切口切開復(fù)位內(nèi)固定治療SandersⅡ型跟骨骨折的療效及安全性相當(dāng),但前者具有手術(shù)時間和住院時間短、治療費用低的優(yōu)勢。
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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備注/Memo

備注/Memo:
2012-06-06收稿 2012-09-15修回
通訊作者:孔建中 E-mail:[email protected]
更新日期/Last Update: 2013-04-30