跟骨粉碎性骨折与远期内侧纵弓损伤的相关性研究  

Correlation between comminuted calcaneal fracture and long-term medial longitudinal arch injury

作　　者：阮文辉[1] 谢鹏[1] 李宏波[1] 旦锋 杨伟兵[1] 杨登峰[1] RUAN Wen-hui;XIE Peng;LI Hong-bo;DAN Feng;YANG Wei-bing;YANG Deng-feng(Department of Bone and Joint Trauma,Hanzhong Central Hospital,Hanzhong Shaanxi 723000,China)

机构地区：[1]汉中市中心医院骨关节创伤科,陕西汉中723000

出　　处：《局解手术学杂志》2023年第1期74-78,共5页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的 研究跟骨粉碎性骨折与远期内侧纵弓损伤的相关性。方法 选取我科行切开复位内固定术的跟骨粉碎性骨折患者24例;观察患者术后即刻、术后3个月、术后6个月、术后9个月及术后12个月的跟骨倾斜角、Bohler角和Gissane角,记录术后12个月的足姿指数(FPI)、弹跳高度、弹跳后足底疼痛情况和足相对高度。将内侧纵弓高度及角度重新命名为足姿指数分项(FPIs),单因素及Logistics回归分析各指标与FPIs的相关性,使用ROC曲线评价模型的区分度,校准曲线及决策曲线评价模型的实用性和收益率,并使用Nomogram图展示。结果 患者各解剖角度均在正常范围内,但Gissane角和Bohler角仍呈增大趋势,跟骨倾斜角呈减小趋势(P<0.05);Bohler角、Gissane角、足相对高度与FPIs呈极弱相关或不相关(P>0.05),弹跳高度和弹跳后足底疼痛VAS评分与FPIs呈中等程度相关(P<0.05),跟骨倾斜角与FPIs呈极强相关(P<0.05);ROC曲线下面积为0.860,说明模型区分度较好,校准曲线趋势尚可,决策曲线收益率高,证明模型建立成功,跟骨粉碎性骨折可能与内侧纵弓损伤有关。结论 跟骨粉碎性骨折远期确实可造成足内侧纵弓损伤。Objective To study the correlation between comminuted calcaneal fracture and long-term medial longitudinal arch injury.Methods A total of 24 patients with comminuted calcaneal fracture who underwent open reduction and internal fixation in our department were selected. The calcaneal inclination angle, Bohler angle and Gissane angle of patients immediately after operation, 3 months after operation, 6 months after operation, 9 months after operation, and 12 months after operation were observed. The foot posture index(FPI),bounce height, plantar pain after bounce and relative foot height 12 months after operation were recorded. The height and angle of the medial longitudinal arch were renamed as foot posture index subitem(FPIs). Univariate analysis and Logistics regression analysis were used to analyze the correlation between each index and FPIs. The ROC curve was used to evaluate the discrimination of model, and the calibration curve and decision curve were used to evaluate the practicality and profitability of the model, and the results were displayed by Nomogram diagram.Results All anatomical angles of the patient were within the normal range, but the Gissane angle and Bohler angle still showed an increasing trend, and the calcaneal inclination angle showed a decreasing trend(P<0.05). Bohler angle, Gissane angle, relative foot height had week or no correlation with FPIs(P>0.05),bounce height and VAS score of plantar pain after bounce had a moderate correlation with FPIs(P<0.05),and calcaneal inclination angle had a strong correlation with FPIs(P<0.05). The area under the ROC curve was 0.860,indicating that the model had good discrimination, the trend of the calibration curve was fair, and the profitability of the decision curve was high, which proved that the model was successfully established, and comminuted calcaneal fracture might be related to medial longitudinal arch injury.Conclusion Comminuted calcaneal fracture can cause medial longitudinal arch injury in the long term.

关 键 词：跟骨骨折 粉碎性 内侧纵弓损伤 模型 

分 类 号：R687.3[医药卫生—骨科学]