植骨在手术治疗跟骨关节内骨折中的作用  

Bone Graft in the Operative Treatment of Intraarticular Calcaneal Fractures

作　　者：孙骏[1] 匡勇[1] 谈绎文[1] 顾新丰[1] 乔琼[1] 

机构地区：[1]上海中医药大学附属曙光医院东院骨科,上海201203

出　　处：《实用骨科杂志》2009年第9期675-677,共3页Journal of Practical Orthopaedics

摘　　要：目的通过前瞻性随机研究,观察植骨在切开复位内固定治疗关节内跟骨骨折中是否有益。方法2001年1月至2005年12月收治需要手术治疗的闭合性关节内跟骨骨折110例,随机分为植骨组和非植骨组。采用"L"形外侧延长切口,直视下显露整个跟骨外侧壁、距下关节后关节面及跟骰关节,给予跟骨骨折复位。对于植骨组采用自体髂骨植骨填充复位后的骨缺损,而非植骨组则不进行植骨。随后将塑形良好的跟骨解剖重建板放置于跟骨外侧壁以固定跟骨骨折。手术前后摄片测量B¨oh ler角,术后采用美国矫形足踝协会踝后足评分标准进行患者的功能评价。结果手术前后植骨组和非植骨组的B¨oh ler角增加没有统计学差异,术后6个月B¨oh ler角的丢失也没有统计学差异,术后6个月、1年及2年的足功能评价也没有差异。结论在手术治疗关节内跟骨骨折中植骨并不具有优势。Objective To determine whether autologous bone graft supplementation with open reduction and internal fixation of intraarticular calcaneal fractures is beneficial by prospective random research. Methods 110 cases of close intraarticular calcaneal fractures which needed open reduction and internal fixation were randomly divided into bone graft group and non-bone graft group from January 2001 to December 2005. Open reduction through the lateral extensile incision,and anatomic reduction of the posterior facet and fixation with anatomic plate were applied.The bone graft group got autologous bone graft supplementation while the non-bone graft group didn＇t. Postoperative and follow-up radiographs assessed Bohler＇s angle. A validated AOFAS ankle hindfoot scale assessed functional outcome after surgery. Results Statistical analysis found no significant difference between the bone graft and non-bone graft patients regarding the change in Bohler＇s angle obtained with surgery and the change in Bohler＇s angle in the six months after surgery. No significant differences in functional outcome were detected at six month,one year and two year after surgery. Conclusion We found no benefit to the use of bone graft supplementation in the operative treatment of intraarticular caleaneal fractures.

关 键 词：B¨ohler角 植骨 关节内跟骨骨折 

分 类 号：R683.42[医药卫生—骨科学]