自固化磷酸钙人工骨与异体骨治疗Sanders Ⅱ-Ⅳ型跟骨骨折的病例对照研究  

Case control study on self setting calcium phosphate cement and allograft for Sanders Ⅱ-Ⅳ fractures of calcaneus

作　　者：许文斌 徐义春[1] 姚辉[1] 侯刚[1] 赵慧清[1] 吕璐璐[1] XU Wen-bin;XU Yi-chun;YA O Hui;HOU Gang;ZHA O Hui-qing;and LYU Lu-lu(Department of Orthopaedics,the Third Af-filiated Hospital of Sun Yat-sen University-Lingnan Hospital,Guangzhou 510000,Guangdong,China)

机构地区：[1]中山大学附属第三医院岭南医院骨科,广东广州510000

出　　处：《中国骨伤》2018年第7期594-598,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:比较自固化磷酸钙人工骨与异体骨植骨联合跟骨锁定重建接骨板内固定治疗SandersⅡ-Ⅳ型跟骨骨折的临床疗效。方法:自2012年3月至2015年12月收治48例SandersⅡ-Ⅳ型跟骨骨折患者,均采用外侧L形切口切开复位内固定术,术中于跟骨体部残留的缺损处进行植骨,根据植骨材料不同分为自固化磷酸钙人工骨组和异体骨组。其中自固化磷酸钙人工骨组28例,男23例,女5例;年龄22～52(34.46±7.33)岁;SandersⅡ型8例,Ⅲ型11例,Ⅳ型9例。异体骨组20例,男17例,女3例;年龄24～55(36.40±7.93)岁;SandersⅡ型6例,Ⅲ型7例,Ⅳ型7例。比较两组患者术后伤口并发症,术前、术后即刻及术后12个月B觟hler角变化情况,并采用Maryland评分对术后12个月功能恢复情况进行评价。结果:所有患者获得骨性愈合,并获得随访,时间12～42个月,平均25个月。两组术前、术后即刻、术后12个月各自B觟hler角比较差异无统计学意义(P>0.05)。两组术后12个月Maryland评分比较差异无统计学意义。异体骨组术后5例出现伤口并发症,自固化磷酸钙人工骨组2例发生切口边缘坏死,两组比较差异无统计学意义(χ2=2.978,P>0.05)。结论 :对于跟骨骨折使用切开复位植骨及重建钢板内固定方法效果良好,与异体骨相比,自固化磷酸钙人工骨作为植骨材料应用于跟骨骨折效果相当,但无排斥反应,可减少相关并发症,临床上值得推广。Objective：To compare clinical results of Sanders Ⅱ-Ⅳfractures of calcaneus treated by self setting calcium phosphate cement and allograft with locking reconstruction bone plate internal fixation. Methods：From March 2012 to December 2015,48 patients with Sanders Ⅱ-Ⅳ fractures of calcaneus were treated by open reduction and internal fixation through L shape incision,bone grafting were performed on reserved bone defect of calcaneal fracture. The patients were divided into self setting calcium phosphate cement and allograft group according to different materials. Twenty eight patients in self setting calcium phosphate cement group,including 23 males and 5 females aged from 22 to 52 years old with an average of（34.46±7.33）years old; 8 cases were typeⅡ,11 cases were type Ⅲ and 7 cases were type Ⅳ according to Sanders classification. Twenty patients in allograft group,including 17 males and 3 females aged from 24 to 55 years old with an average of（36.40±7.93） years old;6 cases were type Ⅱ,7 cases were type Ⅲ and 9 cases were type Ⅳ according to Sanders classification. Postoperative wound complications,B？hler angle before and after operation and 12 months,Maryland functional score were evaluated. Results：All patients obtained bone union,and were followed up from 12 to 42 months with an average of 25 months. There were no statistical significance in B？hler angle and Manyland score before and after operation and 12 months between two groups.Five patients occurred wound complications in allograft group and 2 cases occurred wound complications in self setting calcium phosphate cement and allograft group. Conclusion：Both of open reduction bone grafting and reconstructive plate internal fixation have good effective results for calcaneal fracture. Compared with allograft,self setting calcium phosphate cement,which has no rejection response and less complications,has equal effects for calcaneal fracture and deserves to be popularized.

关 键 词：跟骨 骨折 骨折固定术 内 病例对照研究 

分 类 号：R687.3[医药卫生—骨科学]