跟骨骨折切开复位内固定影响疗效的因素

Related impact factors of calcaneal fractures treated with open reduction and internal fixation

目的：探讨影响跟骨骨折切开复位内固定术的疗效及影响疗效的因素。方法切开复位内固定治疗135例跟骨骨折患者,对影响手术疗效的因素进行统计学分析。结果135例患者获得随访,时间6～12个月。骨折Sanders分类优良率：Ⅱ型83.8%,Ⅲ型骨折76.9%,Ⅳ型骨折51.5%,P＜0.05；合并糖尿病优良率：有糖尿病68.4%,无糖尿病82.5%,P＜0.05；吸烟史优良率：有吸烟史53.1%,无吸烟史78.6%,P＜0.05；固定方式优良率：斯氏针固定53.6%,跟骨钢板75.9%,跟骨锁定钢板固定82.1%,P＜0.05；复位质量优良率：解剖复位76.9%,非解剖复位58.1%,P＜0.05。结论切开复位内固定术治疗跟骨骨折手术疗效好,骨折Sanders分类、骨折固定方式以及骨折复位情况为影响跟骨骨折患者预后的独立危险因素。

Objective To investigate the factors affecting the effect of calcaneal fractures treated by open reduction and internal fixation. Methods 135 cases of calcaneal fractures were treated with open reduction and internal fixa-tion,the factors affecting the efficacy of surgery were analyzed statistically. Results 135 patients were followed up for 6~12 months. Excellent-good rate of fracture types：typeⅡ83. 8%,Ⅲ76. 9%,Ⅳ51. 5%,P〈0. 05;diabetes excellent-good rate：diabetes was 68. 4%, no diabetes was 82. 5%,P〈0. 05; smoking excellent-good rate：53. 1%of smoking history, no history of smoking 78. 6%,P〈0. 05; fixation excellent-good rate： Steinmann pin fixation of 53. 6%, 75. 9% of calcaneal plate, locking plate fixation of calcaneus was 82. 1%,P〈0. 05;reset quality excellent-good rate：anatomical 76. 9%, non-anatomical 58. 1%,P〈0. 05. Conclusions It has the good efficacy for open re-duction and internal fixation with calcaneal fractures, and fractures Sanders classification, fracture fixation and frac-ture reduction calcaneal fractures are independent risk factors for affecting the calcaneal fractures patients.