单轴锁定钢板与多轴锁定钢板治疗Sanders Ⅲ、Ⅳ型跟骨关节内骨折近期疗效对比分析  

COMPARISON OF SHORT-TERM CURATIVE EFFECT OF UNIAXIAL AND POLYAXIAL LOCKING PLATE FIXATION FOR SANDERS TYPE Ⅲ,Ⅳ INTRA-ARTICULAR CALCANEAL FRACTURES

作　　者：宋其合 张小舟 石勇 邱波[3] Song Qihe;Zhang Xiaozhou;Shi Yong(Wuhan University of Science and Technology Affiliated Xiaogan Hospital,Xiaogan 432000,Chin)

机构地区：[1]武汉科技大学附属孝感医院,湖北省孝感市432000 [2]湖北省中西医结合医院 [3]武汉大学人民医院

出　　处：《中国煤炭工业医学杂志》2018年第4期350-354,共5页Chinese Journal of Coal Industry Medicine

基　　金：湖北省自然科学基金项目(编号:2014CFB207)

摘　　要：目的探讨单轴锁定钢板与多轴锁定钢板治疗Sanders Ⅲ、Ⅳ型跟骨关节内骨折近期疗效。方法选取2015年3月—2017年3月本院收治的66例Sanders Ⅲ、Ⅳ型跟骨关节内骨折患者作为研究对象,采用随机数字表法将其分为对照组和观察组,每组33例,对照组采用单轴锁定钢板治疗,观察组采用多轴锁定钢板治疗。比较二组手术时间、术中出血量、骨折愈合时间、Maryland足部评分优良率、影像学指标和并发症发生情况。结果 (1)二组手术时间、术中出血量、骨折愈合时间比较差异均无统计学意义(P>0.05);(2)观察组术后3个月、12个月Bohler角、Gissane角均较对照组明显改善(P<0.05);但二组Maryland足部评分优良率比较差异无统计学意义(P>0.05);(3)观察组术后并发症发生率(3.03%)明显低于对照组(18.18%)(P<0.05)。结论单轴锁定钢板与多轴锁定钢板治疗Sanders Ⅲ、Ⅳ型跟骨关节内骨折近期疗效相似,均能达到较好的骨折愈合效果和足部功能恢复效果,但在维持骨折复位方面多轴锁定钢板治疗的优势更明显,且能有效降低并发症发生率。Objective To compare the shortterm curative effect of uniaxial and polyaxial locking plate fixation for Sanders type Ⅲ、Ⅳ intraarticular calcaneal fractures.Methods Sixty- six cases of Sanders typeⅢ、Ⅳ intraarticular calcaneal fractures treated in author＇s hospital from March 2015 to March 2017 were selected and divided into two groups by random number table method, each with 33 cases.The control group was treated with uniaxial locking plate and the study group was treated with multiaxial locking plates.The opera- tive time,intraoperative blood loss, fracture healing time,excellent and good rate of Maryland foot score,imaging parameters,and complications were compared between the two groups.Results The operative time,intraoperative blood loss and fracture healing time were not significant difference between the two groups （P 0.05）.The Bohler＇s angle and Gissan＇s angle in the study group were significantly better than those in the control group at 3 months and 12 months after operation （P〈0.05） ,but no difference was found in the excellent and good rate of Maryland foot score between the two groups （P〉0.05）.The incidence of postoperative complications in the study group was significantly lower than that in the control group （3.03% vs 18.18%, P〈 0.05）.Conclusion The shortterm curative effect of uniaxial and polyaxial locking plate fixation for Sanders type Ⅲ、Ⅳ intraarticular calcaneal fractures are similar,and both can achieve better fracture healing effects and functional recovery of the foot. However,the advantages of multiaxial locking plates treatment in maintai- ning fracture redvction are more obvious with less incidence of complications.

关 键 词：单轴锁定钢板 多轴锁定钢板 跟骨关节内骨折 近期疗效 

分 类 号：R687.3[医药卫生—骨科学]