锁定钢板外置治疗在老年SandersⅡ~Ⅲ型跟骨骨折患者中的应用效果  

The Application Effect of Locking Plate external Treatment in Elderly Sanders TypeⅡ-ⅢCalcaneal Fractures Patients

作　　者：曹伟 张小玲 朱金华 CAO Wei;ZHANG Xiaoling;ZHU Jinhua(Department of Orthopedics,Xiamen Changgeng Hospital,Xiamen,Fujian Province,361000 China)

机构地区：[1]厦门长庚医院骨科,福建厦门361000

出　　处：《中外医疗》2023年第10期43-48,共6页China & Foreign Medical Treatment

摘　　要：目的探究锁定钢板(locking plate,LP)外置治疗老年SandersⅡ~Ⅲ型跟骨骨折(calcaneal fracture,CF)患者的应用效果。方法随机选取2019年9月—2021年9月厦门长庚医院50例老年SandersⅡ~Ⅲ型CF患者为研究对象,按手术方案的不同分成LP外置组和LP内置组,各25例。对比两组患者优良率、围术期指标、影像学指标、AOFAS评分、Maryland评分、痛介质指标、骨转化标志物指标及并发症发生率。结果LP外置组优良率(88.00%)低于LP内置组(96.00%),但差异无统计学意义(P>0.05)。LP外置组术中失血量较LP内置组少,切口长度及手术时长较LP内置组短,差异有统计学意义(P<0.05)。术后3 d,两组Gissane角均较术前降低,Bohler角均较术前升高,差异有统计学意义(P<0.05)。术后3个月,两组AOFAS、Maryland评分均较术前升高,差异有统计学意义(P<0.05)。术后3 d,两组血清SP、5-HT、PGE-2水平均较术前降低,LP外置组较LP内置组低,差异有统计学意义(P<0.05)。术后1个月,两组血清P1NP、β-CTX水平均较术前降低,血清BSAP、NMID水平均较术前升高,LP外置组血清P1NP、β-CTX水平较LP内置组低,血清BSAP、NMID水平较LP内置组高,差异有统计学意义(P<0.05)。LP外置组并发症总发生率(4.00%)低于LP内置组(20.00%),但差异无统计学意义(P>0.05)。结论LP外置与LP内置治疗老年SandersⅡ~Ⅲ型CF患者手术效果相当,均能有效改善踝关节及足部功能,促进骨折复位,但前者更有助于优化围术期指标,调节疼痛介质及骨转化标志物指标,减轻患者疼痛感,促进骨折愈合。Objective To explore the application effect of locking plate(LP)in the treatment of senile patients with SandersⅡ~Ⅲcalcaneal fracture(CF).Methods Fifty elderly patients with CF type SandersⅡ~Ⅲin Xiamen Changgeng Hospital from September 2019 to September 2021 were randomly selected as the research objects,and divided into LP external group and LP internal group according to different surgical protocols,with 25 cases each.The excellent and good rate,perioperative indexes,imaging indexes,AOFAS score,Maryland score,pain medium indexes,bone transformation markers and complication rate of the two groups were compared.Results The excellent and good rate of LP external group(88.00%)was lower than that of LP internal group(96.00%),but the difference was not statistically significant(P>0.05).The intraoperative blood loss in the LP external group was less than that in the LP internal group,and the incision length and operation time were shorter than that in the LP internal group,and the difference was statistically significant(P<0.05).On the 3 d after surgery,Gissane angle was lower and Bohler angle was higher in both groups than before surgery,and the difference was statistically significant(P<0.05).3 months after surgery,the AOFAS and Maryland scores of the two groups were higher than those before surgery,and the difference was statistically significant(P<0.05).3 d after surgery,the serum levels of SP,5-HT and PGE-2 in two groups were lower than those before surgery,and the levels in LP external group were lower than those in LP internal group,and the difference was statistically significant(P<0.05).One month after surgery,the levels of serum P1NP andβ-CTX were decreased in both groups,while the levels of serum BSAP and NMID were increased in both groups.The levels of serum P1NP andβ-CTX in LP external group were lower than those in LP internal group,while the levels of serum BSAP and NMID were higher than those in LP internal group,and the difference was statistically significant(P<0.05).The total incidence of

关 键 词：锁定钢板 跟骨骨折 骨折复位 疼痛介质 骨转化标志物 

分 类 号：R4[医药卫生—临床医学]