【摘要】 目的比较应用解剖钢板进行植骨或不植骨治疗累及距下关节面的跟骨骨折的临床疗效。方法选取解剖钢板植骨或不植骨治疗跟骨骨折42例,A组(植骨组)23例,B组,(不植骨)19例,分别行骨折切开复位内固定并(或不并)植骨术。测量患者术前术后B?hler角度,依据Maryland足部功能评分进行功能评价后进行对比。结果患者均获得随访,骨折愈合良好,功能恢复满意。A组B?hler角术前10.07°±2.66°,术后29.04°±4.75°,术后1年34.29°±2.39°;B组B?hler角术前9.64°±2.79°,术后30.90°±5.53°,术后1年35.12°±2.04°,两组间没有统计学差异(P>0.05);两组患者术后6个月,12个月Maryland足部功能评分,术后6个月A组优良率78.3%;B组优良率84.2%。术后12个月A组优良率87.0%;B组优良率84.2%。没有统计学差异(P>0.05)。结论切开复位解剖钢板内固定植骨并未表现出比不植骨更好的临床疗效,术者应该结合手术费用、术后排异反应、远期治疗效果等综合因素选择手术方案。更多还原

【Abstract】 Objective To compare the effect of anatomy locking plate combining or not combining bone graft for calcaneal fracture involved subtalar joint surface. Methods 42 calcaneal fracture cases were randomly divided into bone graft group(23) and no bone graft group(19), two groups were offered bone grafting and without grafting respectively. Based on the measurement of preoperative and postoperative Bohler Angle, according to the Maryland standard, evaluating the foot function. Results All patients were fine after surgery, there are no statistical difference in the Bohler Angle in postoperative(29.04°±4.75°, 30.90°±5.53°) and 1 year after surgery(34.29°±2.39°, 35.12°±2.04°). Similarly, two groups have no statistical difference in Maryland standard after 6 months and 12 months, the excellent and good rate of Maryland standard were 78.3%, 84.2% and 87.0%, 84.2% in group A and B after 6 and 12 months, with no statistic difference. Conclusion Anatomy locking plate combining bone grafting has not received superior effect compared with no bone grafting for calcaneal fracture. Surgeons should rationally choice operation plan based on expense, rejection reaction, long-term effect and so on.更多还原