移位型跟骨关节内骨折保守治疗与手术治疗的疗效对比分析  

Operative Versus Non-operative Treatment of Displaced Intra-articular Calcaneal Fractures

作　　者：陈路遥[1] 黄俭[1] 韦展图[1] 吴玮伟[1] 胡世锵[1] 王小平[1] 

机构地区：[1]南方医科大学附属小榄医院骨一科,中山528415

出　　处：《中国现代手术学杂志》2016年第2期115-119,共5页Chinese Journal of Modern Operative Surgery

摘　　要：目的比较移位型跟骨关节内骨折保守治疗与手术治疗的疗效。方法 2008年2月-2014年2月本院收治的312例移位型跟骨关节内骨折患者临床资料,其中手术组101例,保守组211例,对比两组患者的临床疗效。结果两组患者手术前后组间比较,跟骨高度、跟骨宽度、Bohler角、Gissane角等测量结果差异无统计学意义（P〉0.05）。术后,手术组的AOFAS在疼痛、功能、对线及总分上均明显高于保守组,差异有统计学意义（P〈0.05）。手术组优良率为85.15%,明显高于保守组的66.82%,差异有统计学意义（P〈0.05）。手术组皮肤坏死、感染、神经损伤等并发症发生率为5.94%,明显低于保守组的17.54%,差异有统计学意义（P〈0.05）。结论与保守治疗对比,手术治疗移位型跟骨关节内骨折,疗效更高,有利于降低并发症发生率,改善患者疼痛程度,促进术后功能恢复,值得临床推广。Objective To compare the conservative treatment and surgery for the displaced intra-articular calcaneal fractures. Methods From February 2008 to February 2014,there were 312 patients admitted to our hospital with displaced intra-articular calcaneal fractures,including 101 cases in the surgical group,and 211 cases in the conservative group. Results The preoperative and postoperative measurements such as the calcaneal height,the heel width,the Bohler angle and the Gissane angle had no statistically significant difference between the two groups（ P〉0. 05）. After surgery,the scores of AOFAS were significantly higher than the conservative group（ P〈0. 05）. Excellent rate of the surgical group was significantly higher than the conservative group,which was 85. 15% VS 66. 82%（ P〈0. 05）. The complication rate of the surgical group was significantly lower than the conservative group,which was 5. 94% VS 17. 54%（ P〈0. 05）.Conclusion Comparing with the conservative treatment,the surgical treatment for displaced articular calcaneal fractures has the advantages of high efficacy,few complications,high improvement of the foot pain,and high promotion of the functional recovery.

关 键 词：跟骨骨折 内固定器 保守治疗 

分 类 号：R687.3[医药卫生—骨科学]