植骨与非植骨治疗跟骨骨折的疗效比较

The efficacy comparison for treatment of calcaneal fractures with or without bone graft

目的比较植骨与非植骨结合解剖型钢板手术治疗累及距下关节跟骨骨折临床疗效。方法应用植骨与非植骨结合解剖型钢板治疗跟骨骨折46例(植骨组23例,非植骨组23例)。植骨组取自体髂骨或异体骨植骨填充缺损,复位后解剖型钢板内固定,术后8周开始完全负重行走;非植骨组复位后单纯解剖型钢板内固定,术后12周开始完全负重行走。对两组患者手术前后的Bhler角进行测量,并采用Maryland足部功能评分对术后6个月、1年、2年的功能情况进行随访比较。结果 46例患者均获得随访,时间24～34个月。术后Bhler角恢复两组差异无统计学意义(P>0.05);术后6个月、1年、2年Maryland足部功能评分两组差异均无统计学意义(P>0.05)。结论植骨在手术治疗跟骨骨折中对后期的功能恢复未显示明显的提高,但对患者的早期功能锻炼和生活质量改善具有一定意义。

Objective To compare the effect of displaced calcaneal fractures treated by plates with or without bone graft.Methods 46 patients with displaced calcaneal fractures were treated by plates with or without bone graft(divided into the bone graft group with 23 patients and non-bone graft group with 23 patients).Bone was filled defects with plates fixation for the bone graft group,and the patients began to walk after eight weeks;Plates fixation were performed for non-bone graft group,and the patients began to walk after twelve weeks.The Bhler angle was measured before and after operation.The foot function of two groups were compared according to Maryland standard at the 6 months,1 year,and 2 years after operation.Results All patients were followed up for 24-34 months.There was no significant difference in the recovery of Bhler angle between two groups(P>0.05).After 6 months,1 year,2 years,there was no significant difference in the foot function between two groups(P>0.05).Conclusions Bone graft in the surgical treatment of calcaneal fractures is not an advantage in the long term.But it is beneficial in early-walk.