闭合复位锁定钢板外置和切开复位锁定钢板内置治疗SandersⅡ、Ⅲ型跟骨骨折的临床对照研究  

Clinical control study on closed reduction and external fixation versus open reduction and internal fixation with locking plate for the treatment of Sanders Ⅱ and Ⅲ type calcaneus fractures

作　　者：徐小峰[1] 魏长宝[1] 黄永辉[1] 左华[1] 孟晨[1] 陈奇[1] 

机构地区：[1]江苏大学附属医院骨科,江苏镇江212001

出　　处：《江苏大学学报（医学版）》2016年第3期240-243,共4页Journal of Jiangsu University：Medicine Edition

摘　　要：目的:比较闭合复位锁定钢板外置术和切开复位锁定钢板内置术治疗SandersⅡ、Ⅲ型跟骨骨折的临床效果及安全性。方法:选取符合标准的52例SandersⅡ、Ⅲ型跟骨骨折患者作为研究对象,随机分为两组。研究组25例以撬拨复位皮外放置锁定钢板固定进行治疗,对照组27例采用传统的切开复位内固定进行治疗。在两组患者性别、年龄、致伤原因等可能混杂因素具有可比性的基础上,比较两组手术时间、术中出血量、术中X线暴露时间、术后软组织感染发生情况以评价手术安全性,比较两组术后的Bohler角和Gissane角改善程度、骨折愈合时间及术后1年足功能评分以评价手术效果。结果:与对照组相比,研究组手术时间短、术中出血量少、软组织感染率低,差异均有统计学意义(P<0.05),术中X线暴露时间无明显差异(P>0.05);两种术式均能明显改善Bohler角和Gissane角(P<0.05),改善程度无明显差异(P>0.05),两组均未观察到骨折延迟愈合或不愈合的病例,两组间骨折愈合时间的差异无统计学意义(P>0.05)。术后1年,两组足功能均恢复满意,Maryland评分优良率无明显差异(P>0.05)。结论:撬拨复位皮外放置锁定钢板治疗SandersⅡ、Ⅲ型跟骨骨折,能够取得与传统术式相同的临床效果,但手术创伤更小、手术时间更短、术后软组织感染率低,具有一定的优势。Objective ： To compare the clinical curative effect and safety of closed reduction and external fixation versus open reduction and internal fixation with locking plate for the treatment of Sanders Ⅱ and Ⅲ type ealcaneus fractures. Methods： A total of 52 patients with Sanders Ⅱ and Ⅲ type calcaneus fracture were selected according to the standards. A total of 52 patients,25 cases underwent treatment of locking plate as external fixation at random as the research group, and the others were treated with lateral L-shaped incision for open reduction and internal fixa- tion as the control group. There was no significant difference in gender, age, cause of injury, side of injury between two groups （P 〉 0.05 ）. Evaluating the safety of the surgery by comparing the operating time, intraoperative blood loss, intraoperative X-ray exposure time, postoperative complications between two groups. X-ray measures the angle of Bohler and Gissane, meanwhile, the condition of fracture clinical healing were recorded. At last follow-up, the foot function was evaluated with Maryland score system. Results： The operation time, intraoperative blood loss, postoperative complications in research group was significantly less than that in control group （ P 〈 0.05 ）. Two groups of intraoperative X-ray exposure duration were no significant difference （ P 〉 0.05 ）. Two groups of postoper- ative radiological indicators were better than that of the preoperative （ P 〈 0.05 ） , but there were no significantly sta- tistical differences between the two groups （ P 〉 0.05 ）. X-ray films indicated that all cases in two groups obtainedfracture healing, there was no significant difference in the fracture healing time between two groups （ P 〉 0.05 ）. At last follow-up, the Maryland score and good result rate were no statistic significance （P 〉 0.05 ）. Conclusion： Using the locking compression plate as external fixation to treat Sanders Ⅱ and Ⅲ type calcaneus fracture is an effec-tive way when co

关 键 词：跟骨骨折 锁定钢板 骨折外固定术 

分 类 号：R683.42[医药卫生—骨科学]