微创钉中钉闭合复位内固定对跟骨粉碎性骨折患者患肢功能及预后的影响OA
Effect of Minimally Invasive Nail-in-nail Closed Reduction and Internal Fixation on Limb Function and Prognosis in Patients with Calcaneal Comminuted Fracture
目的 研究微创钉中钉闭合复位内固定对Sanders分型Ⅱ、Ⅳ型跟骨粉碎性骨折患者患肢功能及预后的影响.方法 依据随机数字表法将 2020 年 1 月-2022 年 1 月于北京市昌平区中西医结合医院收治的 60 例Sanders分型Ⅱ、Ⅳ型跟骨粉碎性骨折患者分为对照组和研究组,每组 30 例.对照组实施切开复位锁定钢板内固定治疗,研究组实施微创钉中钉闭合复位内固定治疗.比较两组临床疗效、跟骨情况(跟骨Böhler角、Gissane角、跟骨宽度、跟骨高度及跟骨长度)、足部功能(踝关节稳定性、活动度、外观、行走距离、疼痛)、并发症发生率(感染、皮缘坏死、腓肠外侧皮神经损伤).结果 与对照组总有效率的 76.67%比较,研究组总有效率更高,达 96.67%(P＜0.05);与术前比较,两组术后 6 个月跟骨宽度更低,而Böhler角、Gissane角、跟骨长度、跟骨高度更高(P＜0.05),而组间跟骨宽度、Böhler角、Gissane角、跟骨长度、跟骨高度比较,差异无统计学意义(P＞0.05).与术前比较,两组术后 6 个月足部功能各项目评分更高(P＜0.05),而组间足部功能各项目评分比较,差异无统计学意义(P＞0.05);与对照组并发症发生率的 50.00%比较,研究组并发症发生率更低,仅为 3.33%(P＜0.05).结论 微创钉中钉闭合复位内固定治疗在Sanders分型Ⅱ、Ⅳ型跟骨粉碎性骨折患者中的应用效果确切,能够改善患者跟骨情况,提高患者足部功能,且安全性较高.
Objective To study the effect of minimally invasive nail-in-nail closed reduction and internal fixation on limb function and prognosis in patients with Sanders type Ⅱ and Ⅳ calcaneal comminuted fractures.Methods According to the random number table method,60 patients with Sanders type Ⅱ and Ⅳ calcaneal comminuted fractures admitted to Beijing Changping District Hospital of Integrated Traditional Chinese and Western Medicine from January 2020 to January 2022 were divided into control group and study group,each group had 30 patients.The control group was treated with open reduction and locking plate internal fixation,and the study group was treated with minimally invasive nail-in-nail closed reduction and internal fixation.The clinical efficacy,calcaneal condition(calcaneal Böhler angle,Gissane angle,calcaneal width,calcaneal height and calcaneal length),foot function(ankle stability,activity,appearance,walking distance,pain)and complication rate(infection,skin edge necrosis,lateral sural cutaneous nerve injury)were compared between the two groups.Results Compared with the total effective rate of 76.67％in the control group,the total effective rate of the study group was higher,reaching 96.67％(P<0.05).Compared with before operation,the calcaneal width of the two groups was lower at 6 months after operation,while the Böhler angle,Gissane angle,calcaneal length and calcaneal height were higher(P<0.05),but there were no significant difference in calcaneal width,Böhler angle,Gissane angle,calcaneal length and calcaneal height between the two groups(P>0.05).Compared with before operation,the scores of each item of foot function in the two groups were higher at 6 months after operation(P<0.05),but there were no significant difference in the scores of each item of foot function between the two groups(P>0.05).Compared with 50.00％of the incidence of complications in the control group,the incidence of complications in the study group was lower,only 3.33％(P<0.05).Conclusion Minimally invasive nail-in-nail closed reduction and internal fixation is effective in the treatment of Sanders type Ⅱ and Ⅳ calcaneal comminuted fractures,which can improve the calcaneal condition and foot function of patients,and has high safety.
刘佳正
北京市昌平区中西医结合医院骨一科,北京 102208
医药卫生
微创钉中钉闭合复位内固定跟骨粉碎性骨折患肢功能
Minimally invasive nail-in-nail closed reduction and internal fixationCalcaneus comminuted fractureLimb function
《医学信息》 2026 (1)
145-149,5
评论