[1]刘佳正.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[J].医学信息,2026,39(01):145-149.[doi:10.3969/j.issn.1006-1959.2026.01.027]
 LIU Jiazheng.Effect of Minimally Invasive Nail-in-nail Closed Reduction and Internal Fixation on Limb Functionand Prognosis in Patients with Calcaneal Comminuted Fracture[J].Journal of Medical Information,2026,39(01):145-149.[doi:10.3969/j.issn.1006-1959.2026.01.027]
点击复制

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()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
39卷
期数:
2026年01期
页码:
145-149
栏目:
照护实践信息
出版日期:
2026-01-01

文章信息/Info

Title:
Effect of Minimally Invasive Nail-in-nail Closed Reduction and Internal Fixation on Limb Functionand Prognosis in Patients with Calcaneal Comminuted Fracture
文章编号:
1006-1959(2026)01-0145-05
作者:
刘佳正
北京市昌平区中西医结合医院骨一科,北京 102208
Author(s):
LIU Jiazheng
The First Department of Orthopedic, Beijing Changping District Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 102208, China
关键词:
微创钉中钉闭合复位内固定跟骨粉碎性骨折患肢功能
Keywords:
Minimally invasive nail-in-nail closed reduction and internal fixation Calcaneus comminuted fracture Limb function
分类号:
R683.4
DOI:
10.3969/j.issn.1006-1959.2026.01.027
文献标志码:
A
摘要:
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B?觟hler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B?觟hler角、Gissane角、跟骨长度、跟骨高度更高(P<0.05),而组间跟骨宽度、B?觟hler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。
Abstract:
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 B?觟hler 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 B?觟hler angle, Gissane angle, calcaneal length and calcaneal height were higher (P<0.05), but there were no significant difference in calcaneal width, B?觟hler 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.

参考文献/References:

[1]唐华林,付加贵,邹华勇.“U”型外侧切口结合锁定钢板内固定治疗跟骨粉碎性骨折的效果分析[J].组织工程与重建外科杂志,2020,16(5):406-409.[2]毛仁群,王培吉,李文庆,等.切开复位钛板内固定治疗跟骨粉碎性骨折[J].中国矫形外科杂志,2019,27(10):943-945.[3]阮文辉,谢鹏,李宏波,等.跟骨粉碎性骨折与远期内侧纵弓损伤的相关性研究[J].局解手术学杂志,2023,32(1):74-78.[4]曾恒,占新华,赵椰枫.微创钢板螺钉内固定治疗粉碎性跟骨骨折的临床疗效[J].中国骨与关节损伤杂志,2019,34(6):651-653.[5]Antoine F,John E,Thierry F,et al.Three-dimensional computed tomography analysis and functional results of calcaneal fractures treated by an intramedullary nail[J].International Orthopaedics,2019,43(12):2839-2847.[6]梁就积,甘艺荣,陈有弟,等.关节镜联合跟骨钉中钉系统与跗骨窦小切口内固定治疗SandersⅡ、Ⅲ型跟骨骨折的疗效比较[J].转化医学杂志,2024,13(7):1080-1084.[7]胡晓伟,孙开强,厉运收,等.跗骨窦撬拨复位经皮钉中钉内固定微创治疗跟骨骨折[J].实用手外科杂志,2023,37(1):76-79.[8]舒景坤,李红,赵连伟,等.钉中钉内固定系统治疗跟骨骨折[J].临床骨科杂志,2022,25(4):594.[9]马龙,刘波,吴刚强,等.跟骨“钉中钉”内固定系统治疗SandersⅡ、Ⅲ型跟骨骨折[J].中国骨与关节损伤杂志,2023,38(12):1317-1319.[10]吴世奇.跟骨骨折内固定手术中跟骨前部螺钉的置钉策略研究[J].中医正骨,2021,33(5):19-23.[11]黄杰,刘瑾,张建伟.经皮复位微创跟骨钉中钉固定治疗SandersⅡ型及Ⅲ型跟骨骨折[J].中国骨伤,2023,36(4):313-319.[12]刘峻宏,巫宗德,鲍沁蔚,等.闭合撬拨复位经皮螺钉内固定术与斜置塑形钢板内固定术在舌形跟骨骨折中的疗效对比[J].生物骨科材料与临床研究,2023,20(6):62-65,72.[13]李玉香,王晓,陈建良.关节镜辅助下排钉技术结合支撑螺钉固定治疗SandersⅡ型跟骨骨折[J].临床骨科杂志,2025,28(1):127-129.[14]Fascione F,Mauro DM,Guelfi M,et al.Surgical treatment of displaced intraarticular calcaneal fractures by a minimally invasive technique using a locking nail: A preliminary study[J].Foot and Ankle Surgery,2019,25(5):679-683.[15]周顺利,查丽霞,魏小华,等.联合3D打印技术、载距突螺钉导向器治疗SandersⅢ、Ⅳ型跟骨骨折的临床疗效分析[J].生物骨科材料与临床研究,2022,19(5):39-45.[16]张弛,金成龙,黄晓涛,等.小切口切开复位全螺纹空心螺钉与微创解剖锁定接骨板治疗SandersⅡ、Ⅲ型跟骨骨折的短期疗效比较[J].中华骨与关节外科杂志,2019,12(10):796-799,804.[17]谢小飞,罗安玉,黄琛,等.带锁髓内钉固定、钢板螺钉固定和跟骨牵引加夹板固定治疗合并开放性胫腓骨骨折的多发性损伤患者效果分析[J].解放军医药杂志,2021,33(7):46-49,62.[18]黄朱宋,陈翔,蓝锦福,等.3D打印空心钉导板辅助空心钉联合小钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折疗效观察[J].中国骨与关节损伤杂志,2021,36(6):642-644.[19]段霄,张智勇,陈宗文,等.经跗骨窦小切口无头加压螺钉与外侧L形切口钢板固定治疗跟骨骨折的对比研究[J].中国现代医学杂志,2023,33(15):15-20.[20]张鑫,李军,许新忠.闭合复位交锁髓内钉和微创经皮钢板内固定治疗胫骨中下段骨折的疗效及并发症比较[J].中国现代医生,2020,58(6):81-85.

更新日期/Last Update: 1900-01-01