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find Keyword "跟距关节" 2 results
  • SURGICAL TREATMENT OF CALCANEAL FRACTURE INVOLVING TALOCALCANEAL AND CALCANEOCUBOID JOINTS

    Objective To explore the method and effectiveness of lateral calcaneal U-shaped incision approach to treat calcaneal fractures involving the talocalcaneal and calcaneocuboid joints. Methods Between January 2009 and March 2011, 36 cases of calcaneal fractures involving the talocalcaneal and calcaneocuboid joints were treated by the lateral calcaneal U-shaped incision approach and calcaneal anatomical plate fixation. There were 27 males and 9 females with an average age of 38.7 years (range, 19-58 years). According to the Sanders classification criteria, there were 12 cases of type II, 20 cases of type III, and 4 cases of type IV. The Bouml;hler and Gissane angles were (6.21 ± 10.48)° and (89.85 ± 12.34)°, respectively. The average time from injury to surgery was 4.2 days (range, 2-14 days). Results Superficial skin flap necrosis and wound exudate occurred in 1 case respectively, which were cured after dressing change; primary healing was obtained in the other cases. All the cases were followed up 12-26 months (mean, 15.2 months). The X-ray films showed that all fractures healed with an average healing time of 10.6 weeks (range, 8-12 weeks). The reduction of articular surface was satisfactory, and the heel height returned to normal. No complication of breakage of internal fixation or traumatic arthritis occurred. The Bouml;hler and Gissane angles were (29.64 ± 5.33)° and (121.75 ± 6.65)°, respectively at 3 months after operation, showing significant differences when compared with the preoperative values (t=43.800, P=0.000; t=33.200, P=0.000). The average time of plate removal was 11.2 months (range, 9-20 months). According to Maryland foot score, the results were excellent in 17 cases, good in 15 cases, and fair in 4 cases; the excellent and good rate was 88.9%. Conclusion The lateral calcaneal U-shaped incision approach is an effective method to treat calcaneal fractures involving the talocalcaneal and calcaneocuboid joints, which can expose the fracture fully, restore the anatomy of the calcaneal bone, and do early exercise under the condition of rigid internal fixation.

    Release date:2016-08-31 04:06 Export PDF Favorites Scan
  • 涉及跟距关节的跟骨骨折手术治疗

    目的 总结跟骨钢板内固定治疗涉及跟距关节的跟骨闭合性骨折的临床疗效。 方法 2004 年4 月- 2008 年6 月,采用经足跟部外侧延长的L 形切口显露跟骨,切开复位跟骨钢板内固定治疗高处坠落伤所致涉及跟距关节的跟骨骨折18 例。其中男12 例,女6 例;年龄26 ~ 57 岁,平均37 岁。左侧7 例,右侧11 例。骨折按Sanders 分型:Ⅱ型12 例,Ⅲ型5 例,Ⅳ型1 例。术前常规行跟骨侧位、轴位X线片及CT 检查,骨折均累及距下关节并伴有不同程度移位,Gissane 角及Bouml;hler 角明显减小。受伤至手术时间5 ~ 7 d。 结果 术后3 d 1 例伤口感染,术后5 d 1 例创缘部分缺血坏死,经对症治疗后伤口愈合;余患者切口均Ⅰ期愈合。18 例均获随访,随访时间8 ~ 12 个月,平均10 个月。X 线片示所有患者骨折均达骨性愈合,愈合时间2 ~ 4 个月,平均3 个月。末次随访时Gissane 角及Bouml;hler 角均较术前明显改善。术后8 个月,按Maryland 足部评分标准,获优5 例,良10 例,差3 例,优良率83.3%。 结论 切开复位跟骨钢板内固定是治疗涉及跟距关节的跟骨骨折的一种有效方法。

    Release date:2016-08-31 05:47 Export PDF Favorites Scan
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