Sanders Ⅳ型复杂跟骨关节内骨折经单轴与多轴锁定钢板治疗疗效对比  

Comparison of uniaxial and polyaxial locking plate fixation for Sanders types Ⅳ intra-articular calcaneal fractures

作　　者：闫玉[1] 刘兴国[1] 杨益宏[1] 杨文斌[1] Yan Yu;Liu Xingguo;Yang Yihong;Yang Wenbin(WDepartment of Orthopaedics,Xi'an Gaoxin Hospital,Xi'an 710075,China)

机构地区：[1]西安高新医院骨科,710075

出　　处：《中国医师进修杂志》2019年第2期105-108,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的对比Sanders Ⅳ型复杂跟骨关节内骨折经单轴与多轴锁定钢板治疗的临床疗效。方法对2012年1月至2016年12月收治的Sanders Ⅳ型复杂跟骨关节内骨折72例患者资料做回顾性分析,其中A组采用单轴锁定钢板治疗(38例),B组采用多轴锁定钢板治疗(34例),对比两组患者手术情况、骨折愈合情况及影像学资料,以Maryland足部评分对临床疗效进行评估。结果A、B组手术时间比较均差异无统计学意义(P>0.05)。A组术后随访(23.2±5.4)个月,B组术后随访(22.5±4.9)个月,两组患者均骨性愈合。B组术后3、12个月Bohler角[(31.6±4.5)°比(27.6±6.1)°、(30.7±4.2)°比(27.0±5.4)°]和Gissane角[(109.2±10.8)°比(96.8±9.5)°、(107.3±10.1)°比(95.4±10.2)°]均较A组增高,均差异有统计学意义(P<0.05)。末次随访时B组Maryland足部评分优良率为91.2%(31/34),与A组的84.2%(32/38)比较差异无统计学意义(P>0.05)。结论Sanders Ⅳ型复杂跟骨关节内骨折经单轴或多轴锁定钢板治疗均可获得较好骨折愈合,而多轴锁定钢板在维持跟骨关节内骨折复位方面更有优势且更有利于足部功能恢复。Objective To compare the radiographic and clinical outcomes of uniaxial and polyaxial locking plates used in the treatment of Sanders types Ⅳ intra-articular calcaneal fractures.Methods A retrospective comparative study was performed on the 72 patients with Sanders types Ⅳ intra-articular calcaneal fractures who had been treated by uniaxial locking plates (A group,38 cases) or polyaxial locking plates (B group,34 cases) between January 2012 and December 2016. Operation time,intraoperative bleeding,union time,radiological and functional outcomes and functions by the Maryland foot score were compared between the two groups.Results There were no significant differences between the two groups in operation time,intraoperative bleeding,or union time (P>0.05). The patients in A group were followed up for (23.2±5.4) months,and those in B group were followed up for (22.5±4.9) months. All the patients obtained bony union. B group displayed significantly better Bohler angles [(31.6±4.5)° vs. (27.6±6.1)°,(30.7±4.2)° vs.(27.0±5.4)°] and Gissane angles [(109.2±10.8)° vs. (96.8±9.5)°,(107.3±10.1)° vs. (95.4±10.2)°] at 3 and 12 months after operation,compared with A group (P<0.05). Evaluated by the Maryland foot score,the excellent and good rate for the B group was 91.2%(31/34),which was insignificantly higher than that for the A group (84.2%,32/38)(P>0.05).Conclusions Both uniaxial locking and polyaxial locking plates can lead to satisfactory therapeutic outcomes for Sanders types Ⅳ intra-articular calcaneal fractures,but polyaxial locking plates may be superior in stability and functional recovery.

关 键 词：跟骨 骨折 锁定钢板 骨折固定术 

分 类 号：R687.3[医药卫生—骨科学]