Sanders Ⅲ、Ⅳ型跟骨关节内骨折内固定术中植骨与不植骨的疗效比较  

Comparison of bone grafting and non-grafting for bone defects in open reduction and internal fixation of Sanders type Ⅲ, Ⅳ calcaneal fractures

作　　者：陈林 李武 胡艇 赵友明[2] 韦盛旺[2] 

机构地区：[1]温州市中心医院骨科,浙江325000 [2]温州医科大学附属第二医院创伤骨科

出　　处：《中国骨与关节损伤杂志》2017年第4期382-385,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的比较Sanders Ⅲ、Ⅳ型跟骨关节内骨折行切开复位内固定治疗术中植骨与不植骨的临床疗效。方法笔者自2010-01—2014-12采用切开复位内固定治疗97例Sanders Ⅲ、Ⅳ型跟骨关节内骨折,植骨组62例,不植骨组35例。比较植骨组与不植骨组的放射学结果、术后一般情况、并发症、足部功能评分等。结果本组97例获平均1.8(1~3)年随访。术后开始负重时间植骨组(12.1±1.5)周,不植骨组(13.8±1.3)周,植骨组术后开始负重时间早于非植骨组,差异有统计学意义(P<0.05)。2组在术后2年随访时植骨组跟骨Bohler角丢失情况优于非植骨组,差异有统计学意义(P<0.001)。2组术后住院天数、复位质量、并发症、骨折愈合情况、足部功能评分等方面比较,差异均无统计学意义(P>0.05)。结论对于SandersⅢ、Ⅳ型跟骨关节内骨折,植骨治疗可早期负重行走,并可减少术后远期Bohler角丢失。Objective To compare the treatment outcomes of open reduction and internal fixation （ORIF） with and without bone grafting for displaced intra-articular Sanders type Ⅲ, Ⅳ calcaneal fractures with bone defects. Methods The reduction and internal fixation were performed for 97 cases of Sanders type Ⅲ, Ⅳ, intra-articular calcaneal fractures between January 2010 and December 2014 including the bone graft group of 62 cases and the non bone graft group of 35 cases. The radiology results, general conditions after operation, complications and foot function score were compared between the bone graft group and non bone graft group. Results Ninety seven cases received an average of 1.8 （1-3）years follow-up. Postoperative weight bearing time was （12.1±1.5）weeks in bone graft group, （13,8±1.3）weeks in non bone graft group, the bone graft group was earlier than the non bone graft group, the difference was statistically significant （P 〈0.05）. Bohler angle loss at 2 years follow-up after surgery in the bone graft group was better than that in the non bone graft group, the difference was statistically significant （P 〈0.001）. In the postoperative hospitalization days, reduction, complications, fracture healing and foot function score between two groups, there were no statistically significant differences （P 〉0.05）. Conclusion In the treatment of displaced intra-articular calcaneal fractures with bone defects, ORIF with bone grafting allows earlier postoperative full weight bearing than non-grafting, and reduces Bobler＇s angle loss.

关 键 词：跟骨骨折 植骨 骨缺损 内固定 

分 类 号：R687.3[医药卫生—骨科学]