跟骨外固定器和解剖型跟骨钛板固定治疗跟骨骨折疗效比较  

Comparition of external fixator fixation and anatomic calcaneal titanic plate fixation in the treatment of calcaneal fracture

作　　者：李勇[1] 陈文[1] 边竞[1] 刘小涛[1] 李彬彬[1] 龚泰芳[1] LI Yong CHEN Wen BIAN Jing LIU Xiao-tao LI Bin-bin GONG Tai-fang.(Department of Orthopedic, Taihe Hospital of Shiyan City, the Affiliated Hospital of Hubei University of Medicine, Shiyan 442000, Hubei, CHIN)

机构地区：[1]十堰市太和医院湖北医药学院附属医院骨关节科,湖北十堰442000

出　　处：《海南医学》2017年第1期63-66,共4页Hainan Medical Journal

基　　金：湖北省高校产学研合作资助项目(编号:C2010049)

摘　　要：目的比较跟骨外固定器与解剖型跟骨钛板治疗跟骨骨折的临床疗效。方法设计跟骨外固定器,并选取我院2010年1月至2014年1月需手术治疗的跟骨骨折90例(96足),按照随机数字表法分为两组各45例(48足),其中A组采用跟骨外固定器固定治疗,B组采用解剖型跟骨钛板内固定治疗。比较两组患者的手术时间、术中出血量、术后并发症,术后Bohler角、Gissane角、Maryland评分。结果 90例患者均获得随访10~18个月,平均15.6个月。A、B两组手术时间平均分别为(60.85±4.57)min、(89.56±5.32)min,术中出血量平均分别为(9.35±3.56)ml、(98.62±4.73)m L,两组比较差异有统计学意义(P<0.05);A组患者术后早期并发症发生率为6.3%,术后仅3例出现针道分泌物。B组早期并发症发生率为27.1%,发生浅表感染5足,深部感染1足,局部皮缘坏死7足,两组比较差异有统计学意义(P<0.05);A组患者术后晚期并发症发生率为8.3%,术后2足发生创伤性距下关节炎,2足发生踝关节僵硬。B组术后晚期并发症发生率为10.4%,发生创伤性距下关节炎5足。A、B两组患者术后Bohler角平均分别为(26.98±0.75)°、(27.06±0.94)°,Gissane角平均分别为(122.82±2.36)°、(123.20±2.01)°,Maryland评分平均分别为(90.75±3.25)分、(88.63±5.27)分。两组患者的晚期并发症发生率、Bohler角、Gissane角、Maryland评分比较,差异均无统计学意义(P>0.05)。结论跟骨外固定器固定和解剖型跟骨钛板内固定治疗跟骨骨折均能取得良好的临床疗效,但前者较后者更有优势,可作为优先选择的治疗方法。Objective To compare the clinical outcomes of external fixator fixation and anatomic calcaneal titanic plate fixation in the treatment of calcaneal fractures. Methods We designed external fixator by ourselves to treat calcaneal fractures. From January 2010 to January 2014, a total of 90 patients（96 feet） suffered from calcaneal fractures,who needed operative treatment in our hospital, were selected and divided into the group A and group B according to random number table, with 45 cases（48 feet） in each group. The group A was treated with external fixation of calcaneal fixation, and the group B was treated by using anatomic calcaneal titanic plate internal fixation. The operation time, blood loss, complication rate, the Bohler angle and Gissane angle after operation, Maryland Foot Score were compared by the statistical analysis. Results All patients were followed up for 15.6 months averagely（10 to 18 months）; the operative time and intraoperative blood loss of group A and group B were（60.85±4.57） min,（89.56±5.32） min,（9.35±3.56） m L,（98.62±4.73） m L, respectively, and the differences between the two groups were statistically significant（P0.05）. The incidence of early postoperative complications of group A was 6.3%, and only 3 cases had needle channel secretion after operation; the incidence of early postoperative complications of group B was 27.1%, with 5 superficial infections of feet,1 foot-deep infection, 7 local skin edge necrosis of feet; the differences between the two groups were statistically significant（P0.05）. The incidence of long-term postoperative complications of group A was 8.3%, with 2 traumatic arthritis of feet, 2 ankle stiffness of feet; the incidence of long-term postoperative complications of group B was 10.4%, with 5 traumatic arthritis of feet. The postoperative Bolher angle, Gissane angle, Maryland Foot Score were respectively（26.98 ±0.75）°,（122.82 ± 2.36）°,（90.75 ± 3.25） in group A and（27.06 ± 0.94）°,（123.20 ± 2.01）°,（8

关 键 词：跟骨骨折 自制外固定器 解剖型跟骨钛板 疗效 

分 类 号：R683.42[医药卫生—骨科学]