【摘要】 目的探讨跟骨骨折复位质量与踝-后足功能恢复效果的相关性。方法收集2012年12月至2015年12月广州增城区人民医院、珠海市人民医院治疗并随访1年以上的46例(55足)跟骨骨折患者的临床资料。测量X线平片跟骨解剖形态学参数(跟骨长度、宽度、高度、Gissane角及Bohler角)以及CT冠状面后距下关节面最大移位距离,将所得数据与患者美国足踝外科学会(AOFAS)踝-后足功能评分结果进行相关性分析。结果患者获随访12~18个月(平均14.7个月)。随访1年时AOFAS足踝功能评分为(82.8±8.2)分,优良率75%。经多元线性回归分析,发现与AOFAS评分相关的指标是后距下关节面移位距离和Bohler角,前者与AOFAS评分呈负相关(r=–0.551,P<0.05),后者与AOFAS评分呈正相关(r=0.357,P<0.05);AOFAS评分与跟骨长度、宽度、高度及Gissane角均无相关性(P>0.05)。结论跟骨后距下关节面平整度和Bohler角对踝-后足功能恢复效果影响较大,尤其是后距下关节面平整度,可作为跟骨骨折预后的判断指标。更多还原

【Abstract】 Objective To explore the correlation between reduction quality of calcaneal fracture and anklehindfoot functional recovery. Methods Clinical data of 46 patients(55 feet) with calcaneal fracture treated from December 2012 to December 2015 in Zengcheng District People’s Hospital of Guangzhou and Zhuhai People’s Hospital and followed up over 12 months were collected. Anatomic morphological parameters such as the length,width, height, Gissane angle and Bohler angle of the calcaneus in X-ray images were measured, the maximum displacement of the posterior subtalar articular surface in calcaneal CT coronal section were recorded, and the correlations between the above data and patients’ American Orthopaedic Foot and Ankle Society(AOFAS) ankle hindfoot score were analyzed. Results Patients were followed up from 12 to 18 months(average, 14.7 months).At 1 year after the treatment, the average AOFAS score was(82.8 ± 8.2) point, with the good and excellent rate of 75%. By multiple linear regression analysis, we could find that maximum displacement of the posterior subtalar articular surface and Bohler angle were all related to AOFAS score, which the former was negatively(r = – 0.551, P <0.05) and the latter was positively(r = 0.357, P <0.05) correlating to AOFAS score. No correlations were found among AOFAS score and the length, width, height and Gissane angle of calcaneus(P >0.05). Conclusion Both posterior subtalar articular surface flatness and Bohler angle have been proved to impact on the recovery of ankle-hindfoot function significantly, especially the former, could be used as an indicator in the judgement of calcaneal fracture prognosis.更多还原