普通解剖钢板联合自体髂骨植骨治疗SandersⅡ、Ⅲ型跟骨骨折的效果评价

Effect evaluation of common anatomical plate and autologous iliac bone graft in the treatment of Sanders Ⅱ and Ⅲ calcaneal fractures

目的分析普通解剖钢板联合自体髂骨植骨治疗SandersⅡ、Ⅲ型跟骨骨折的临床疗效。方法回顾性分析56例SandersⅡ、Ⅲ型跟骨骨折患者临床资料,按使用钢板的不同将患者分为两组。A组30例采用普通解剖钢板联合自体髂骨植骨治疗,B组26例采用锁定钢板内固定治疗。收集并比较两组患者的手术时间、住院时间、术后辅助下地时间等,以及患者入院时和1年后的跟骨结节关节角(Bohler角)、跟骨交叉角(Gissane角)等资料。结果 B组的手术时间为(61.38±7.36)min、住院时间为(13.16±1.43)d、辅助下地时间为(4.11±1.67)d均低于A组,差异有统计学意义(P<0.05)。A组和B组患者术后1年Bohler角[(31.460±4.790)vs.(31.080±4.370)]、Gissane角[(116.360±1.280)vs.(116.040±1.450)]等均较入院时改善(P<0.05),但组间比较,差异无统计学意义(P>0.05)。结论普通解剖钢板联合自体髂骨植骨在治疗SandersⅡ、Ⅲ型跟骨骨折时,在院指标不如锁定钢板有优势。

Objective To analyze the effect of common anatomical plate combined with autologous iliac bone graft in the treatment of Sanders Ⅱand Ⅲcalcaneal fractures. Methods The clinical data of 56 cases of Sanders Ⅱand Ⅲcalcaneal fractures were retrospectively analyzed, and the patients were divided into two groups according to different plates. The group A has 30 patients, and they were treated with common anatomical plate and autologous iliac bone graft. The group B has 26 patients, and they were treated with locking plate fixation. The clinical indicators such as the time of operation, length of hospital stay, and postoperative ambulation time were collected and compared between the two groups, as well as the data of Bohler angle, calcaneus crossing angle at admission and 1 year after the operation. Results The time of operation was （61.38±7.36） min, the length of hospital stay was （13.16±1.43） d and postoperative ambulation time was （4.11±1.67） d in the group B, which were lower than those in the group A, the difference was statistically significant （P〈 0.05）. The Bohler joint angles[ （31.460±4.790） vs. （31.080±4.370）], Gissane angles [（116.360±1.280） vs. （116.040±1.450）] of the patients in the group A and group B were improved after 1 year compared to those of at admission （P〈0.05）, but the difference was not statistically significant between the two groups （P〉0.05）. Conclusion In the treatment of Sanders Ⅱ and Ⅲcalcaneal fractures, the common anatomical plate combined with autologous iliac bone graft has certain advantages than locking plate fixation in clinical indicators.