跟骨骨折的微创治疗与切开复位内固定术的对比研究  

Comparative study of minimally invasive treatment with open reduction and internal fixation for calcaneal fractures

作　　者：李洪帅[1] 李坤[1] 张鹏[1] 

机构地区：[1]河北省廊坊市人民医院骨科,河北廊坊065000

出　　处：《中国医药导报》2016年第21期103-106,共4页China Medical Herald

基　　金：河北省廊坊市科学技术研究与发展计划项目(2014013005c)

摘　　要：目的比较微创钢板固定复位手术与切开复位内固定术治疗跟骨骨折的临床效果和安全性。方法选取2013年5月~2014年12月在廊坊市人民医院接受治疗的跟骨骨折患者85例为研究对象,随机分为两组:微创手术组(42例)和开放手术组(43例)。分别接受微创钢板内固定术和切开复位内固定术。比较两组患者的B觟hler角、Gissane角、术后足功能等级及并发症发生情况。结果手术治疗后,两组患者的B觟hler角及Gissane角均较术前明显提高(P<0.01),微创手术组的B觟hler角明显高于开放性手术组(t=2.381,P<0.05);经Ridit检验,术后两组患者的足功能均较术前得到明显改善(t_(Ridit)=17.643,P<0.05;t_(Ridit)=12.710,P<0.05);但是术后微创手术组患者的足功能改善更佳(t_(Ridit)=2.067,P<0.05);两组各类并发症的发生率比较差异无统计学意义(P>0.05);并发症总发生率比较差异无统计学意义(χ~2=2.70,P>0.05)。结论微创钢板内固定术治疗跟骨骨折,手术切口小,术后并发症较少,可牢固固定骨折,改善足功能,具有较高的临床应用价值。Objective To compare the clinical curative effect and safety of minimally invasive plate fixation and open reduction and internal fixation for the treatment of caleaneal fractures. Methods The medical records of 85 patients with ealcaneal fractures from May 2013 to December 2014 in the People＇s Hospital of Langfang City were analyzed, which were randomly divided into two groups： minimally invasive surgery group （42 cases） and open surgery group （43 cases） to receive minimally invasive plate fixation and open reduction and internal fixation surgery, respectively. The Bfihler angel, Gissane angel, postoperative foot function and postoperative complications were compared between the two groups. Results After surgery treatment, BShler angle and Gissane angle of the two groups of patients were signifi- cantly improved compared with before surgery （P 〈 0.01）, and B^hler angle of minimally invasive plate fixation group significantly higher than that of the open surgery group （t = 2.381, P 〈 0.05）. After Ridit test, the foot function of pa- tients after operation in the two groups were significantly improved （tRidit = 17.643, P 〈 0.05; tRidit = 12.710, P 〈 0.05）. But the postoperative foot function of minimally invasive plate fixation group were improved better （tRidit = 2.067, P 〈 0.05）. There were no significant differences in the incidence of all kinds of complications in the two groups （P 〉 0.05） and the overall incidence of complications of the two groups was no statistically significant differences （X2 = 2.70, P 〈 0.05）. Conclusion Minimally invasive plate fixation in the treatment of calcaneal fractures has advantages of small sur- gical incision and less postoperative complications. The fractures with a high clinical value can be firmly fixed and the foot function is improved.

关 键 词：跟骨骨折 微创钢板固定 切开复位 足功能 

分 类 号：R687.3[医药卫生—骨科学]