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透视下小切口骨刀撬拨治疗跟骨骨折的临床应用研究*
Study on the clinical application of osteotome prying to treat calcaneal fractures under the c-arm X-ray perspective
  
DOI:
中文关键词:  微创  跟骨骨折  小切口  经骨折间隙  骨刀撬拨  空心螺钉
英文关键词:Minimally invasive  Calcaneal fracture  Small incision  Interfracture space  Osteotome prying  Hollow screw
基金项目:
作者单位
杨宏志 廖建平 王溪淳 胡斌 张钰 杨永华  
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中文摘要:
      目的 探讨C臂机透视下跟骨骨折跗骨窦区小切口骨刀经骨折间隙撬拨复位经皮螺钉内固定的临床研究。方法 收集40例跟骨骨折作为研究对象,其中20例患者采用传统切开复位内固定手术来进行治疗作为对照组;另外20例患者则采用C臂机透视下跗骨窦区小切口骨刀经骨折间隙撬拨复位经皮空心螺钉内固定来进行治疗作为观察组。对比两组患者治疗效果,然后对两组患者的手术时间、住院时间、住院费用、手术后的疼痛程度、Böhler角,Gissane角进行对比,最后观察在治疗后两组患者出现局部皮瓣坏死感染的发生率及治疗效果的优良率。结果 观察组手术时间、住院时间、住院平均费用均明显少于对照组,观察组手术后的疼痛程度明显轻于对照组,差异均有统计学意义(P<0.05)。两组患者术后Böhler角,Gissane角的恢复情况,差异无统计学意义(P>0.05)。观察组中,在手术后未出现局部皮瓣坏死感染。对照组中,在手术后出现局部皮瓣坏死的患者有4例,占20%,组间差异有统计学意义(P<0.05)。两组优良率对比差异不大,无统计学意义。结论 采用C臂机透视下跟骨骨折跗骨窦区小切口骨刀经骨折间隙撬拨复位经皮螺钉内固定术来治疗跟骨骨折,手术创伤小、时间短、住院费用较少,并能有效的避免传统切开复位内固定引起的局部皮瓣坏死感染等并发症,能取得非常理想的临床效果,患者伤口美观,值得临床推广。
英文摘要:
      Objective To explore the clinical study of small incision osteotomy prying to treat calcaneal fractures through Interfracture space under the c-arm X-ray perspective. Methods 40 calcaneal fractures were collected as subjects, of which 20 patients were treated with traditional open restoration and internal fixation as the control group. Another 20 patients were treated with the small incision osteotomy prying restoration and hollow screw internal fixation through Interfracture space in the sinus of the tarsal bone under the c-arm X-ray perspective as the observation group. The treatment effect of the two groups of patients was compared, and then the operation time, hospitalization time, hospitalization expenses, postoperative pain degree, BöhlerAngle and Gissane Angle were compared, and finally the incidence rate of local skin flap necrosis infection and the excellent and good rate of treatment effect were observed. Results The operation time, hospitalization time and average hospitalization cost of the observation group were significantly lower than those of the control group, and the pain degree of the observation group was significantly lower than that of the control group, with statistically significant differences (P< 0.05). Postoperative recovery of Böhler Angle and Gissane Angle was not statistically significant (P> 0.05). In the observation group, local skin flap necrosis and incision infection did not appear after surgery. In the control group, there were 4 cases of local skin flap necrosis after surgery, accounting for 20%, and the difference between the groups was statistically significant (P< 0.05). There was no significant difference in excellent rate between the two groups. Conclusion The treatment of calcaneal fractures with the small incision osteotomy prying restoration and hollow screw internal fixation through Interfracture space in the sinus of the tarsal bone under the c-arm X-ray perspective, small surgical trauma, short time and hospitalization costs less, and can effectively avoid the traditional open reduction and internal fixation of local skin flap necrosis caused by complications such as infection, can obtain ideal clinical effect, bring patients beauty appearance, worth clinical promotion.
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