扩大切口钢板固定跟骨关节内骨折疗效的相关因素分析  

Analysis of related factors to effect of enlarged incision with plate fixation for intra-articular calcaneal fracture

作　　者：赵国志[1] 彭义[1] 刘奕蓉 曲家富[1] 曹立海[1] ZHAO Guozhi;PENG Yi;LIU Yirong;QU Jiafu;CAO Lihai(Department of Ankle Surgery, The Second Hospital of Tang Shan, Hebei Tang Shan 063000, China;Department of Anatomy, North China University of science and Technology, Hebei Tang Shan 063210, China)

机构地区：[1]唐山市第二医院足踝外科,河北唐山063000 [2]华北理工大学基础医学院解剖学系,河北唐山063210

出　　处：《足踝外科电子杂志》2018年第3期22-25,33,共5页Electronic Journal of Foot and Ankle Surgery

基　　金：河北省科技计划项目(14277737D)

摘　　要：目的探讨扩大切口钢板固定跟骨关节内骨折的影响因素和疗效。方法选取唐山市第二医院足跟骨关节内骨折298足病例,手术方式均为扩大切口钢板内固定。观察内容包括损伤程度(Sanders分型)、术前术后跟骨的B?hler角(B角)、Gissane角(G角)及美国矫形足与踝关节协会(AOFAS)评分和相应的评估等级。临床检查依照AOFAS踝与后足评分系统进行评分。所得数据使用SPSS统计软件进行分析。结果所有患者AOFAS平均得分(86.78±8.18)分,优良率91.6%。Sanders分型级别越高,受伤程度越重,AOFAS评分越低,临床效果越差(P=0.00)。跟骨术前、术后B角异常者较术前、术后B角正常者AOFAS评分低,临床效果差;跟骨术后G角异常较术后G角正常者AOFAS评分低,临床效果差。结论 Sander分型级别高治疗效果差,术后B角异常治疗效果差,术后G角度恢复越接近正常值,AOFAS评分越高。Objective To investigate the effect and influence factor of enlarged incision plate fixation for intra-articular fractures of the calcaneus.Methods A total of298cases of intra-articular calcaneal fractures in our hospital were selected.All of them were accepted incision with plate fixation.The study included the degree of injury(typing),the B?hler's angle of the calcaneus before and after operation,the Gissane angle,and the AOFAS score and the corresponding assessment level.Clinical examinations were scored according to the American Society of Orthopedic Foot and Ankle Association's squat and hind foot scoring system.The data obtained were analyzed using SPSS statistical software.Results The average AOFAS score of all patients was(86.78±8.18),and the excellent and good rate was91.6%.The higher the Sanders classification is,the more serious the injury is,the lower the AOFAS score is,the worse the clinical effect is(P=0.00).The AOFAS score of patients with abnormal B-angle before and after calcaneus surgery was lower than that of patients with normal B-angle before and after operation.The AOFAS score of patients with abnormal G angle after calcaneal operation was lower than that of normal G angle after operation,and clinical effect is poor.Conclusion Patients with higher Sander classification were less effective in treatment.Patients with abnormal B angle after operation have poor therapeutic effect.The more normal Postoperative G Angle recovery,the higher AOFAS score.

关 键 词：跟骨 跟骨骨折 骨折固定术 钢板 影响因素 

分 类 号：R687.3[医药卫生—骨科学]