锁定钢板结合同种异体骨植骨治疗Sanders Ⅱ型、Sanders Ⅲ型跟骨骨折病例对照研究  

Case Control Study on Locking Plates Fixation Combined with Allograft for the Treatment of Sanders Type Ⅱand Ⅲ Calcaneal Fractures

作　　者：王波[1] 张广程[1] 狄东华[1] 赵建忠[1] 

机构地区：[1]江苏大学附属医院骨一科,江苏镇江212000

出　　处：《黑龙江医学》2014年第12期1354-1356,共3页Heilongjiang Medical Journal

摘　　要：目的探讨锁定钢板结合同种异体骨植骨治疗SandersⅡ型、SandersⅢ型跟骨骨折的临床疗效。方法选择2011-06-2013-06间采用锁定钢板结合同种异体骨植骨治疗的50例SandersⅡ型、SandersⅢ型跟骨骨折患者,其中SandersⅡ型组25例,SandersⅢ型组25例,比较两组临床疗效。结果所有患者均获随访,时间12-18个月,平均（14.34±2.82）个月。SandersⅡ型组术后bohler角（33.46°±4.22°）,Gissane角（114.26°±3.83°）;SandersⅢ型组术后bohler角（32.14°±3.85°）,Gissane角（122.58°±4.32°）,两组bohler角、Gissane角与术前比较均有明显改善（P〈0.05）。SandersⅡ型组术后皮缘坏死或愈合不良1例,骨折愈合时间（11.6±3.5）周,术后Maryland评分优18例、良5例、可2例,优良率92%;SandersⅢ型术后皮缘坏死或愈合不良2例,骨折愈合时间（12.1±3.2）周,术后Maryland评分优14例、良8例、可3例,优良率88%,两组术后切口不良、愈合时间及优良率比较,差异无统计学意义（P〉0.05）。结论锁定钢板结合同种异体骨植骨治疗SandersⅡ型、SandersⅢ型跟骨骨折临床疗效相似,关键在于解剖复位、合理植骨、坚强固定。Objective To analyze clinical effects of locking plates fixation combined with allograft for the treatment of Sanders type Ⅱand Ⅲ calcaneal fractures. Methods From June,2011 to June,2013,50 patients with Sanders type Ⅱand Ⅲ calcaneal fractures were treated with locked plate fixation combined with allograft. There were 25 patients in Sanders typeⅡ group. The clinical effects of two groups were compared. Results All cases had been followed up for 12 - 18 months,with an average of（ 14. 34 ± 2. 82） months. Sanders typeⅡ group had an average bohler angle of（ 33. 46° ± 4. 22°） and an average Gissane angle of（ 114. 26° ± 3. 83°） after surgery; Sanders type Ⅲgroup had an average bohler angle of（ 32. 14° ± 3. 85°） and an average Gissane angle of（ 122. 58° ± 4. 32°） after surgery; the postoperative bohler angle and Gissane angle of two groups were improved significantly compared with preoperative bohler angle and Gissane angle（ P 0. 05）. Sanders typeⅡ group had poor healing in 1 case,with an average fracture healing time of（ 11. 6 ± 3. 5） weeks and Maryland good rate of 92%; Sanders type Ⅲ group had poor healing in 2 cases,with an average fracture healing time of（ 12. 1 ± 3. 2） weeks; and Maryland good rate was 88%,including 14 excellent cases,8 relatively good cases,and 3 normal cases. In two groups of postoperative incision,healing time and was compared. There was no statistically significant difference of postoperative incision,healing time and Maryland good rate between two groups（ P 〉0. 05）. Conclusion Locking plate combined with allograft for the treatment of Sanders type Ⅱand Ⅲcalcaneal fractures has the similar clinical curative effects. The key is anatomical repositioning,reasonable bone graft and strong fixation.

关 键 词：跟骨 骨折 植骨 内固定 

分 类 号：R687.4[医药卫生—骨科学]