跟骨骨折手术Gissane角的恢复与预后的关系  

The relationship between restoring Gissane angle and prognosis in calcaneal fracture surgery

作　　者：郑磊[1,2] 秦书俭[1] 

机构地区：[1]辽宁医学院基础医学院,辽宁锦州121000 [2]辽宁省普兰店市中心医院骨一科,116200

出　　处：《中国医师进修杂志》2015年第10期748-750,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨跟骨骨折手术Gissane角的恢复与预后之间的关系。方法选择住院手术治疗的SandersⅡ～Ⅲ型单侧跟骨骨折、Gissane角改变大于15。的患者40例，均进行跟骨骨折切开复位钢板内固定手术治疗。其中25例（试验组）参考健侧足跟骨X线片，术中将Gissane角恢复。另15例（对照组）术中未将Gissane角恢复。在术后1周通过X线片测量两组跟骨高长比，术后6和12个月分别对两组患者进行Maryland评分。结果试验组术后跟骨高长比高于对照组（0．60±0．04比0．55±0．05），差异有统计学意义（P〈0．05）。40例患者均获得随访。术后6和12个月，试验组Maryland评分高于对照组[（88．9±5．7）分比（80．5±7．3）分和（89．5±5．5）分比（82．5±6．4）分]，差异均有统计学意义（P〈0．05）。结论恢复Gissane角有利于跟骨骨折的预后，在临床上跟骨骨折手术需要尽可能参照健侧来恢复Gissane角。Objective To explore the relationship between restoring Gissane angle and prognosis in calcaneal fracture surgery. Methods Forty patients with single side calcaneal fracture （Sanders Ⅱ - Ⅲ）, Gissane angle changed more than 15° and having performed open reduction and internal fixation with steel plate were enrolled. In them, 25 patients （experimental group） recovered Gissane angle in surgery referencing the healthy side with X-rays. Another 15 patients （control group） didn＇t recover Gissane angle. The ratio of calcaneum height and length was measured at 1 week after surgery. At 6 and 12 months after surgery, the function were valued by Maryland score. Results The ratio of calcaneum height and length in experimental group was significantly higher than that in control group： 0.60 ± 0.04 vs. 0.55 ± 0.05, and there was statistical difference （P 〈 0.05）. All the patients were followed up. At 6 and 12 months after surgery, the Maryland score in experimental group were significantly higher than those in control group： （88.9 ± 5.7） scores vs. （80.5 ± 7.3） scores and （89.5 ± 5.5） scores vs. （82.5 ± 6.4） scores, and there were statistical differences （P 〈 0.05）. Conclusions Restoring Gissane angle is benefitial for prognosis. So in calcaneal fracture surgery, the Gissane angle should be recovered as much as possible referencing the healthy side.

关 键 词：跟骨 骨折 Gissane角 

分 类 号：R687.3[医药卫生—骨科学]