跟骨锁定钢板内固定对伴骨质疏松跟骨关节内骨折患者关节复位丢失的预防效果研究  

Research on the prevention effect of internal fixation of keel locking plate for the loss of joint reduction in intra-articular calcaneal fractures patients with osteoporosis

作　　者：李峰[1] 范达文[1] 张修春 庞争取[1] LI Feng;FAN Da- wen;ZHANG Xiu- chun;PANG Zheng- qu(Department of Orthopaedics, The First People＇s Hospital Of Aksu ,Akesu 843000, Chin)

机构地区：[1]阿克苏地区第一人民医院骨科,新疆阿克苏843000

出　　处：《现代医学》2018年第2期136-140,共5页Modern Medical Journal

摘　　要：目的:探讨跟骨锁定钢板内固定对伴骨质疏松跟骨关节内骨折患者关节复位丢失的预防效果。方法:选取伴骨质疏松跟骨关节内骨折患者86例,随机分为观察组与对照组,每组43例。观察组在用锁定钢板内固定,对照组采用解剖钢板内固定。比较两组围手术期相关指标、术后12个月美国足踝外科协会(AOFAS)踝-后足评分及足踝功能优良率,术前及术后1周、6个月、12个月B9hler角、Gissane角、跟骨宽度、跟骨高度及其丢失度。结果:两组患者的切口长度、手术时间、术中出血量、术后住院时间比较差异无统计学意义(P>0.05),观察组的骨折愈合时间较对照组明显缩短(P<0.05);末次随访时,观察组的B9hler角、Gissane角、跟骨宽度、跟骨高度丢失度显著低于对照组(P<0.05);观察组的AOFAS评分及足踝关节功能恢复优良率显著高于对照组(P<0.05)。结论:跟骨锁定钢板内固定对伴骨质疏松跟骨关节内骨折疗效显著,相较于解剖钢板能够减少关节复位丢失。Objective：To evaluate the preventive effect of internal fixation of keel locking plate for the loss of joint reduction in intra-articular calcaneal fractures patients with osteoporosis.Methods：86 intra-articular calcaneal fractures patients with osteoporosis were randomly divided into observation group and control group,with43 cases in each group.The observation group received internal fixation of keel locking plate,the control group received internal fixation of anatomical plate.The perioperative related indicators,scores of American Orthopaedic Foot Ankle Society（AOFAS）at 12 months after operation and the excellent rate of ankle function between the two groups were compared,the B9 hler angle,Gissane angle,calcaneus width,calcaneus height before operation and1 week,6 months,12 months after operation and its degree loss were evaluated.Results：There were no significant differences in the incision length,operation time,intraoperative blood loss and postoperative hospital stay between the two groups（P 〉 0.05）,the healing time of the fractures in the observation group was significantly shorter than that in the control group（P 〈 0.05）;At the last follow-up,the loss of B9 hler angle,Gissane angle,calcaneal width and calcaneus height in the observation group were significantly lower than in that the control group（P 〈 0.05）;The AOFAS score and excellent rate of ankle function in the observation group were significantly higher than those in the control group（P 〈 0.05）.Conclusion：The internal fixation of calcaneal locking plate is effective in the treatment of intra-articular calcaneal fractures patients with osteoporosis,which can reduce the loss of joint reduction compared with anatomical plate.

关 键 词：跟骨关节内骨折 骨质疏松 切开复位 内固定 锁定钢板 

分 类 号：R683[医药卫生—骨科学]