跟骨载距突螺钉导向器基础与临床上的准确性评价

doi:10.13418/j.issn.1001-165x.2015.05.008

中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (5): 523-526.doi: 10.13418/j.issn.1001-165x.2015.05.008

跟骨载距突螺钉导向器基础与临床上的准确性评价

刘丙根¹，　庞清江²，　余霄²，　郭宗慧²，　陈先军²

1.宁波大学医学院，浙江宁波 315211；　2.宁波市第二医院骨科中心，浙江宁波 315010

收稿日期:2014-08-22 出版日期:2015-09-25 发布日期:2015-10-13
通讯作者: 庞清江, 教授，主任医师，硕士生导师，E-mail：pqjey@sina.com
作者简介:刘丙根（1988-）, 男, 在读研究生, 宜春市人，研究方向：跟骨载距突导向器的临床应用及效果评价，E-mail: 450413369@qq.com
基金资助:
宁波市社会发展项目(20l1C50063);宁波市临床特色重点专科项目基金（2013-88）

The accuracy of evaluation in the foundation and clinical application of the self-manufactured guider of the calcaneous sustentaculum tali screw for the fixation of the calcaneous sustentaculum tali

LIU Bing-gen¹, PANG Qing-jiang ², YU Xiao², GUO Zong-hui ², CHEN Xian-jun²

1.School of Medicine of Ningbo University, Ningbo, Zhejiang 315211, China; 2. Department of Orthopaedics, Ningbo No.2 Hospital, Ningbo, Zhejiang 315010, China

Received:2014-08-22 Online:2015-09-25 Published:2015-10-13

摘要/Abstract

摘要：

　目的　探讨自行研制的跟骨载距突螺钉导向器在尸体标本与临床上辅助固定跟骨载距突的准确性。方法　（1）采用30例成人新鲜及防腐足部标本为研究对象，用2.5 mm克氏针沿跟骨载距突螺钉导向器植入载距突内，每具标本打入1枚克氏针，观察克氏针打入载距突情况；（2）在临床上收集跟骨骨折25例(28足),根据Sanders等分型，II型9例，Ⅲ型11例,IV型8例，采用该载距突螺钉辅助治疗跟骨骨折，通过X线检查螺钉打入载距突情况。结果　(1)所有标本均置入1枚固定载距突的克氏针，其中1枚穿过载距突前下，其余29枚均从载距突的中间通过，精确率达96.7%。(2)临床病例X线片显示共置入28枚固定载距突的螺钉，其中1枚穿过载距突前方，其余27枚均从载距突的中间通过，精确率达96.4%。结论　采用该导向器辅助固定跟骨的载距突,明显提高螺钉或克氏针植入载距突的准确性，在临床病例上，避免载距突螺钉位置偏差导致人为医源性并发症的发生,使用方便,适合临床推广应用。

关键词: 跟骨, 骨折, 载距突, 螺钉导向器

Abstract:

Objective　To discuss the accuracy of the self-manufactured guider of the calcaneous sustentaculum tali screw for the fixation of the calcaneous sustentaculum tali in the calcaneous specimens and the clinical.　Methods　(1) 15 pairs of calcaneous specimens were collected for this study. A 2.5 mm Kirschner-wire was drilled into each of the cadaveric feet according to the guider and the position of the Kirschner-wire. (2) 25 cases (28 feet) of calcaneal fracture were enrolled in this study. According to Sanders classification, there were 9 cases falling into type-II，11 cases type-III and 8 cases type-IV. The guider of the calcaneous sustentaculum tali screw was used in each case and the sustentaculum tali screw position was evaluated by X-ray postoperatively.　Results　(1) In the specimens, all of the 30 Kirschner-wires were implanted into the calcaneous sustentaculum tali and 29 Kirschner-wires were passed though the middle of the sustentaculum tali; However, 1 Kirschner-wire was passed through the anteroinferior part of the sustentaculum tali. The accurate rate by this guider was 96.7%. (2) A total of 28 sustentaculum tali screws were implanted in 25 patients, and 27 screws were passed thoughthe middle of the sustentaculum tali. However, 1 screw was passed through the anterior part of the sustentaculum tali. The accuracy rate was 96.4%.　Conclusion　The self-manufactured guider of the calcaneous sustentaculum tali screw can significantly improve the accuracy of the screw or Kirschner-wire being implanted into the sustentaculum tali, which can avoid the artificial iatrogenic complications caused by the position deviation of the sustentaculum tali screw. Therefore, it is appropriate to be promoted widely in clinical practice.

Key words: Calcaneal, Fracture, Sustentaculum tali, Screw with director

刘丙根，庞清江，余霄，郭宗慧，陈先军. 跟骨载距突螺钉导向器基础与临床上的准确性评价[J]. 中国临床解剖学杂志, 2015, 33(5): 523-526.

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跟骨载距突螺钉导向器基础与临床上的准确性评价

The accuracy of evaluation in the foundation and clinical application of the self-manufactured guider of the calcaneous sustentaculum tali screw for the fixation of the calcaneous sustentaculum tali

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