一期开放复位内固定治疗SandersⅣ型跟骨骨折临床疗效的探讨

Clinical Effect of Primary Open Reduction and Internal Fixation in Treatment of Sanders Type IV Calcaneal Fracture

目的研究一期开放复位钢板内固定治疗SandersⅣ型跟骨骨折术中植骨与不植骨的临床疗效比较。方法回顾性选取2020年1月—2021年9月滕州市中心人民医院收治的42例SandersⅣ型跟骨骨折患者作为研究对象,均一期行切开复位内固定术,根据术中是否植骨将其分为研究组和对照组,每组21例。对照组患者均不植骨,研究组患者均植骨,记录并比较两组患者术后并发症、术前术后Bohler角、Gissane角及踝与后足美国足外科协会(AOFAS)评分功能评分。结果两组患者术前、术后3个月跟骨Bohler角、Gissane角及踝与后足AOFAS评分比较,差异无统计学意义(P>0.05);术后1年,研究组跟骨Bohler角、Gissane角及踝与后足AOFAS评分均高于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论Sanders IV型跟骨骨折患者一期开放复位内固定并进行植骨在远期功能恢复上优于不植骨。

Objective Toinvestigate the clinical eff ect of primary open reduction plate internal fi xation in the treatment of Sanders type IV calcaneal fracture with bone grafting and without bone grafting.Methods 42 cases of Sanders type IV calcaneal fracture treated from January 2020 to September 2021 were reviewed,all of which underwent open reduction and internal fi xation in one stage.They were divided into two groups according to whether bone grafting was performed during the operation,with 21 cases in each group.The control group did not have bone grafting while the study group had bone grafting.Preoperative and postoperative AOFAS scores of Bohler Angle,Gissane Angle,ankle and hind foot.Results There were no signifi cant diff erences in AOFAS scores of calcaneus Bohler Angle,Gissane Angle and ankle and hind foot between the two groups before and 3 months after surgery.One year after operation,the AOFAS scores of Bohler Angle,Gissane Angle,ankle and hind foot of the experimental group were higher than those of the control group.There was no signifi cant diff erence in the incidence of complications between the two groups.Conclusion The treatment of Sanders type IV calcaneal fracture with open reduction plate and internal fi xation can achieve ideal clinical results.