采用改良跟骨锁定板治疗Sanders分型Ⅲ~Ⅳ型跟骨骨折的疗效观察  

Observation of efficacy on a modified calcaneal locking plate in treating calcaneal fracture Sanders typeⅢ-Ⅳ

作　　者：高泽 侯福山 李渊[1] 罗华云[1] 李栋[1] Gao Ze;Hou Fushan;Li Yuan;Luo Huayun;Li Dong(Department of Orthopaedics,the Second Hospital of Shanxi Medical University,Taiyuan 030000,China)

机构地区：[1]山西医科大学第二医院骨科,太原030000 [2]山西医科大学,太原030101

出　　处：《骨科临床与研究杂志》2024年第1期43-48,共6页Journal Of Clinical Orthopedics And Research

基　　金：山西省卫生健康委“四个一”重大科技攻关专项项目(2021XM10);山西省科技厅自然科学研究面上项目(202203021211030)。

摘　　要：目的探讨改良跟骨锁定板治疗Sanders分型Ⅲ~Ⅳ型跟骨骨折的疗效。方法回顾性分析山西医科大学第二医院骨科2021年1月至2022年8月期间采用改良跟骨锁定板(改良组)和普通跟骨锁定板(传统组)治疗跟骨骨折Sanders分型Ⅲ~Ⅳ型患者资料,共72例(77足)。记录并比较两组患者的手术时间、术中透视次数、术中出血量、皮瓣愈合情况、住院时间、早期下地负重时间、骨折愈合时间、术后并发症发生情况,术前、术后即刻、术后1年时Bohler角、Gissane角、术后1年足功能(Maryland)评分、美国矫形外科足踝协会踝-后足评分(AOFAS)、足功能指数量表(FFI)、疼痛视觉模拟评分(VAS)。结果改良组手术平均时长、术后早期下地负重时间均短于传统组(P<0.05)。术中出血量、透视次数、平均住院时间、骨折愈合时间均无明显差异。改良组与传统组术后1年相关角度相比差异有统计学意义(P<0.05),表明在负重后,改良组关节面并未有明显塌陷。术后1年随访,改良组优良率、AOFAS评分、FFI指数均优于传统组,VAS评分较传统组更低(P<0.05)。结论改良跟骨锁定板治疗Sanders分型Ⅲ~Ⅳ型的跟骨骨折,可以实现良好的临床和放射学结果,且无严重并发症,有利于患者后足功能的恢复,优良率更高,有一定的临床推广价值。Objective To investigate the efficacy of modified calcaneal locking plate in the treatment of calcaneal fracture Sanders typeⅢ-Ⅳ.Methods The data of 72 patients(77 feet)with calcaneal facture Sanders typeⅢtoⅣtreated with modified calcaneal locking plate or ordinary calcaneal locking plate from January 2021 to August 2022 in the Orthopaedic Department of the Second Hospital of Shanxi Medical University were retrospectively analyzed,and they were divided into the improved group and the traditional group.The operation time,intraoperative fluoroscopy times,intraoperative blood loss,flap healing,hospital stay,early weight-bearing time,fracture healing time,postoperative complications,Bohler angle,Gissane angle and Maryland score immediately and 1 year after surgery,Maryland score,American orthopaedic foot ankle society,foot function index(FFI),visual analogue score(VAS)1 year after surgery were recorded and compared between the two groups.Results The average operation time and the early weight-bearing time in the improved group were shorter than those in the traditional group(P<0.05).There were no significant differences in the amount of blood loss,the number of fluoroscopy,the average length of hospital stay and the healing time of fracture.There was a statistically significant difference in the related angle between the improved group and the traditional group 1 year after surgery(P<0.05),indicating that there was no obvious collapse of the articular surface in the improved group after weight-bearing.After 1 year follow-up,the excellent and good rate,AOFAS score and FFI index of the improved group were better than those of the traditional group,and the VAS was lower than that in the traditional group(P<0.05).Conclusion Modified calcaneal locking plates for Sanders typeⅢ-Ⅳcalcaneal fractures can achieve good clinical and radiological results without serious complications,and is conducive to the recovery of patients'hind foot function with a better distinguished acheiever ratio,which has certain clinical p

关 键 词：跟骨骨折 改良跟骨锁定板 优良率 

分 类 号：R687.3[医药卫生—骨科学]