复位锁定钢板不同放置方式治疗对Sanders Ⅱ、Ⅲ型跟骨骨折患者临床疗效、关节功能及并发症的影响  

Effects of Different Placement Methods of Locking Plate of Open Reduction on Clinical Efficacy,Joint Function and Complications of Patients with Calcaneal Fracture of Sanders TypeⅡand Ⅲ

作　　者：张廷玖[1] 张东[1] 曾凡伟[1] 李智[1] ZHANG Ting-jiu;ZHANG Dong;ZENG Fan-wei;LI Zhi(Department of Orthopaedics,Dazhou Central Hospital,Dazhou,Sichuan 635000,China)

机构地区：[1]达州市中心医院骨科,四川达州635000

出　　处：《解放军医药杂志》2020年第8期79-82,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省卫生和计划生育委员会科研课题(150049)。

摘　　要：目的分析复位锁定钢板不同放置方式治疗对SandersⅡ、Ⅲ型跟骨骨折患者临床疗效、关节功能及并发症的影响。方法选取本院2016年3月—2018年11月收治的56例跟骨骨折患者为研究对象。根据手术方式不同分为A组(采用撬拨复位皮外放置锁定钢板固定术)27例和B组(采用切开复位锁定钢板内固定术)29例。比较2组术中情况(手术时间、术中出血量、术中X线暴露时间)和手术前后跟骨结节关节角(Bohler角)和跟骨交叉角(Gissane角)变化及并发症发生情况。随访1年后,评估2组术后关节功能恢复情况。结果A组手术时间、术中出血量低于B组(P<0.05);与术前相比,2组术后Bohler角和Gissane角有显著改善(P<0.05),但组间比较差异无统计学意义(P>0.05)。A组术后并发症总发生率显著低于B组(P<0.05)。2组术后关节功能恢复优良率比较差异无统计学意义(P>0.05)。结论与切开复位锁定钢板内固定术治疗SandersⅡ、Ⅲ型跟骨骨折比较,撬拨复位皮外放置锁定钢板固定术在减少患者术中出血量、手术时间及术后并发症上具有一定的优势。Objective To analyze the effects of different placement methods of locking plate of open reduction on clinical efficacy,joint function and complications of patients with calcaneal fracture of Sanders typeⅡandⅢ.Methods Fifty-six cases of calcaneal fracture admitted to our hospital from March 2016 to November 2018 were selected as the research subjects.According to different operation methods,the patients were divided into group A(using poking reduction and locking plate external fixation,n=27)and group B(using open reduction and locking plate internal fixation,n=29).The intraoperative conditions(duration of operation,intraoperative bleeding volume,duration of intraoperative X-ray exposure)and the changes of bone nodule joint angle(Bohler angle)and calcaneus cross angle(Gissane angle)before and after operation were compared.After 1-year follow-up,the joint function of the two groups was evaluated.Results The duration of operation and intraoperative bleeding volume of group A were shorter or less than those of group B(P<0.05).The postoperative Bohler angle and Gissane angle of the two groups were significantly improved(P<0.05),but there was no significant difference between the two groups(P>0.05).The total incidence of postoperative complications in group A was significantly lower than that in group B(P<0.05).There was no significant difference in the excellent and good rate of postoperative joint function recovery between the two groups(P>0.05).Conclusion Compared with open reduction and locking plate internal fixation,poking reduction and locking plate external fixation for clinical treatment of SandersⅡandⅢcalcaneal fractures has several advantages,including reducing intraoperative blood loss,duration of operation and postoperative complications.

关 键 词：骨折 跟骨 撬拨复位皮外放置锁定钢板固定术 切开复位锁定钢板内固定术 手术后并发症 出血 关节功能 

分 类 号：R687.3[医药卫生—骨科学]