外固定架结合有限内固定与钢板内固定治疗跟骨关节内骨折比较  

Comparison of clinical effects between external fixator combined with limited internal fixation and plates for treatment of intraarticular calcaneal fractures

作　　者：柴雷子[1] 薛锋 丁亮 沈玉春 赵勇 

机构地区：[1]苏州大学医学部,江苏省苏州市215123 [2]上海市奉贤区中心医院

出　　处：《中国骨与关节损伤杂志》2013年第8期737-739,共3页Chinese Journal of Bone and Joint Injury

基　　金：上海市卫生局科研课题(2007045)

摘　　要：目的探讨外固定架结合有限内固定治疗跟骨关节内骨折的临床疗效。方法78例（86足）跟骨关节内骨折分为2组：A组42例（48足）采用外固定架结合有限内固定治疗；B组36例（38足）采用钢板内固定治疗。对两组骨折愈合时间、跟骨恢复情况、临床疗效、切1：I并发症发生率等指标进行比较。结果78例均获得平均16．8（8—34）个月随访。两组术后跟骨的长度、宽度、高度、Bohler角及Gissane角均得到了良好的恢复，与术前比较差异均有统计学意义（P〈0．05）；但A、B两组术后比较差异无统计学意义（P〉O．05）。临床疗效按Maryland足部评分系统评定：A组优良率89．6％，B组优良率86．8％，两组优良率差异无统计学意义（P〉0．05）。A组切口并发症发生率（4．2％）低于B组（21．1％），差异有统计学意义（P〈0．05）。结论外固定架结合有限内固定治疗跟骨关节内骨折疗效满意，具有微创优点。Objective To investigate the clinical effects of the external fixator combined with the limited internal f＇Lxation for the treatment of intraartieular calcaneal fractures. Methods According to different ways of treatment of intmartieular calcaneal fractures, 78 patients（86 feet） were divided into two groups： 42 patients（48 feet） were treated with the external fLxator combined with the limited internal fixation as group A; 36 patients （38 feet） were treated with plates as group B. Fracture healing time, recovery of the caleaneal, clinical outcomes and the rate of incision complications were compared. Results A total of 78 cases were followed up for 8-34 months （average 16.8 months）. Both group A and B all had acceptable reduction in caleaneal length, height, width, BoMer angle, and Gissane angle, there was significant difference between preoperative and postoperative results（P 〈0.05）, and there was no signieant difference in postoperative results between group A and group B（P 〉 0.05）. Based on the Maryland grading system, excellent rate was 89.6% in the group A, excellent rate was 86.8% in the group B, there were no significant difference between them（P 〉0.05）. The rate of incision complications in the group A was lower than in the group B,there was significant difference between them （4.2% vs 21.1%, P 〈0.05）. Conclusion External fLxator combined with limited internal fLxation for intraartieular caleaneal fractures is satisfactory and minimally invasive.

关 键 词：跟骨关节内骨折 外固定架 钢板螺钉 有限内固定 

分 类 号：R687.3[医药卫生—骨科学]