Kết quả bước đầu điều trị gãy kín xương gót bằng phương pháp kết hợp xương nẹp vít

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Tác giả: Hoàng Lai Phạm, Hoàng Tuấn Võ

Ngôn ngữ: Vie

Ký hiệu phân loại:

Thông tin xuất bản: Y Dược học Cần Thơ 2023

Mô tả vật lý: 48 - 54

Bộ sưu tập: Metadata

ID: 408438

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Tóm tắt
Chủ đề

Gãy xương gót có tới 75% là gãy phạm khớp, trong vài thập niên gần đây có nhiều loại nẹp vít phù hợp hình thể giải phẫu xương gót ra đời đã thúc đẩy xu thế phẫu thuật điều trị gãy xương gót. Nhận xét kết quả sớm điều trị gãy kín xương gót bằng phương pháp kết hợp xương nẹp vít. Nghiên cứu mô tả lâm sàng tiến cứu 24 bệnh nhân với 29 xương gót gãy, phân loại II, III, IV theo Sanders, được phẫu thuật kết hợp xương bằng nẹp vít xương gót, trong thời gian từ tháng 1/2021 đến tháng 1/2023 tại Bệnh viện Trường Đại học Y Dược Cần Thơ và Bệnh viện Đa khoa Trung ương Cần Thơ. Góc Bohler trung bình sau mổ đạt 31,28°±4,64° (trước mổ là 5,31°±5,18°). Góc Bohler trung bình sau mổ 3 tháng đạt 28,75°±4,97°. Thời điểm phẫu thuật trung bình là 8,75±4,88 ngày sau chấn thương. Vết mổ liền sẹo kỳ đầu 28 vết mổ và có 1 vết mổ thiểu dưỡng, liền sẹo muộn. Theo dõi được 29 ổ gãy xương gót sau mổ 4 tháng, chức năng khớp cổ chân theo Rowe là 94,66±10,43 điểm, kết quả chung theo Hall và Pennal đạt: tốt (79,3%), khá (13,8%), trung bình (6,9%) và không có trường hợp nào đạt kết quả xấu. Điểm AOFAS Ankle - Hindfoot Score đạt 86,90±9,69 điểm (55-97 điểm). Phẫu thuật kết hợp xương gót bằng nẹp vít là một lựa chọn điều trị mang lại kết quả phục hồi chức năng khớp cổ chân sau mổ tốt. Tuy nhiên cần thận trọng khi bóc tách vạt chữ L đủ độ dày và nên dẫn lưu vết mổ để tránh nguy cơ thiểu dưỡng và hoạt tử vạt da., Tóm tắt tiếng anh, Calcaneus fractures account for up to 75% are intra-articular fractures. In recent decades, many types of plates suitable for calcaneal anatomy have been introduced, promoting the trend of surgery to treat calcaneus fractures.Evaluate the early results of treatment of closed calcaneal fractures using the osteosynthesis with calcaneal plate. Prospective observational study of 24 patients with 29 calcaneal fractures type II, III, and IV by Sanders' classification had osteosynthesis using the calcaneal plate, between Jan 2021 and Jan 2023 at Can Tho University of Medicine and Pharmacy Hospital, Can Tho Central General Hospital. The mean postoperative Bоhler's angle was 31.28°±4.64° (pre-op 5.31°±5.18°). The mean post-operative 3-month Bоhler's angle was 28.75°±4.97°. The mean time of surgery was 8.75±4.88 days after injury. The incision was primary healing in 28 incisions and there was 1 incision with malnutrition, late healing. Following up with 29 calcaneal fractures 4 months after surgery, the ankle joint function of Rowe was 94.66±10.43 points, the overall results according to Hall and Pennal achieved: very good (79.3%), good (13.8%), average (6.9%), and no cases of poor results. AOFAS Ankle - Hindfoot Score reached 86.90±9.69 points (55-97 points). Calcaneal osteosynthesis with calcaneal plate is a treatment option that brings good results in restoring ankle joint function after surgery. However, be careful with dissect L shape flap of sufficient thickness and should be drainage to avoid the risk of malnutrition and necrosis of skin flaps.

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