【摘要】 目的 :探讨锁定钢板植骨内固定术与传统普通钢板内固定术治疗跟骨骨折的临床疗效比较。方法 :以我院骨科收治的64例跟骨骨折患者为研究对象,采用随机数字表分为对照组与观察组两组,每组各32例,其中对照组采用普通钢板内固定治疗,观察组采用锁定钢板植骨内固定术治疗,记录两组手术情况,包括手术时间、术中出血量、住院时间、骨折愈合时间,同时记录两组术前、出院时及术后6月的B?hler角、Gissame角、跟骨宽度,采用美国足踝外科学会AOFAS踝-后足评估其关节疼痛、关节稳定性、活动受限。并统计随访期间两组骨折畸形愈合、足弓塌陷、腓骨下端撞击综合征等并发症发生。结果 :对照组优良率62.5%,明显低于观察组75.0%;观察组手术时间、术中出血量、住院时间及骨折愈合时间均明显低于对照组;出院时、术后6个月,两组B?hler角、Gissame角明显高于术前,跟骨宽度明显低于术前,术后6个月两组各指标优于出院时,且观察组不同时间点,各指标均优于对照组;出院时对照组AOFAS(73.5±7.6)分,明显低于观察组(85.6±6.8)分,且关节疼痛、稳定性、活动受限评分均低于观察组;术后6个月随访,显示对照组并发症总发生率9.37%,与观察组3.12%无显著差异。结论 :锁定钢板植骨内固定术治疗跟骨骨折疗效较好,明显优于普通钢板内固定术,加快骨折愈合,保证骨折关节面完整,避免术后足弓塌陷等不良反应发生,促进患者康复。更多还原

【Abstract】 Objective To compare the clinical efficacy of locking plate bone grafting internal fixation and traditional plain plate internal fixation in the treatment of calcaneal fractures. Methods 64 cases of calcaneal fracture patients were selected from the department of orthopedics in our hospital for the research and divided into two groups: the control group and the observation group, with 32 cases in each group. The control group was treated with plain plate internal fixation while the observation group was treated with locking plate bone grafting internal fixation. The surgical conditions were recorded between the two groups, including operative time, intraoperative blood loss, hospital stay, fracture healing time. At the same time, the B?hler angle, Gissame angle, calcaneus width were recorded before operation, in the discharge time and 6 months after operation between the two groups. The ankle foot task of the American foot and ankle surgery society AOFAS was used to assess joint pain, joint stability, and limited mobility. And the fracture healing, foot arch collapse, fibular lower impact syndrome and other complications were counted during follow-up of the two groups. Results The good rate of the control group was 62.5%, which was significantly lower than that in the observation group with 75.0%. The operative time, intraoperative blood loss, hospital stays and fracture healing time were significantly lower in the observation group than those in the control group. At the time of discharge, 6 months after operation, B?hler angle, Gissame angle of the two groups were significantly higher than those before operation while the calcaneal width was significantly lower than that before operation. The indicators of the two groups in 6 months after operation were better than those in the discharge time, and the indexes at different times in the observation group were better than those in the control group. The AOFAS(73.5±7.6) points in the control group were significantly lower than that in the observation group with(85.6±6.8) points, and the scores of joint pain, stability and limited activity were significantly lower than those in the observation group. After 6 months follow-up, the total incidence rate of complications in the control group was 9.37%, which was not significantly different from the 3.12% in the observation group. Conclusion Locking plate bone grafting internal fixation in the treatment of calcaneal fractures can have a significantly better effect than plain plate internal fixation, and speed up fracture healing, ensure complete fracture of the articular surface, avoid the occurrence of postoperative arch collapse and other adverse reactions and promote patient rehabilitation.更多还原