SandersⅡ、Ⅲ型跟骨关节内骨折术中不植骨的安全性及疗效研究

The safety and curative effect analysis of no bone graft intraoperatively for Sanders type Ⅱ and type Ⅲ intra-articular calcaneal fractures

目的探讨Sanders Ⅱ、Ⅲ型跟骨关节内骨折术中骨缺损不植骨的安全性及疗效。方法选取笔者医院2011年1月~2014年1月手术治疗的Sanders Ⅱ、Ⅲ型跟骨关节内骨折患者68例76足,根据是否植骨均分成对照组和观察组两组,每组各34例38足。不植骨患者为观察组,植骨患者为对照组,探究其治疗的安全性及疗效。结果随访12~36个月,平均18.6个月,观察组平均手术时间(55.6±5.4)min、平均出血量(52.9±18.2)mL,均明显短于对照组(71.7±7.2)min、(83.1±13.5)mL,差异有统计学意义(P<0.05);观察组术后Bohler’s角、Gissane’s角分别为(32.8±6.4)°、(136.1±7.3)°,与对照组(30.9±5.7)°、(134.5±6.8)°无统计学差异(P>0.05)。结论 Sanders Ⅱ、Ⅲ型跟骨关节内骨折术中骨缺损不植骨治疗具有较高的安全性,可取得较好的临床效果。

Objective To investigate the safety and curative effect of no bone graft intraoperatively for Sanders type Ⅱ and type Ⅲ intra-articular calcaneal fractures with bone defects. Methods Totally 76 feet in 68 patients with Sanders type Ⅱ and type Ⅲ intra-articular calcaneal fractures who underwent surgery from Jan. 2011 to Jan. 2014 were divided into the control group and the observation group with 34 cases（38 feet） in each group according to bone graft or not. Patients without bone graft were as the observation group,and patients with bone graft were as the control group. The safety and curative effect were explored. Results The patients were followed up 12 to 36 months with an average of 18. 6 months. The average operation time of（55. 6 ± 5. 4） min and the average volume of blood loss of（52. 9 ± 18. 2） mL in the observation group were significantly shorter than those in the control group,and the differences were statistically significant（P〈0. 05）. Postoperative Bohler＇s angle and Gissane＇s angle were（32. 8 ± 6. 4） ° and（136. 1 ± 7. 3） ° respectively in the observation group,and there was no statistical difference compared with the control group（ P〉0. 05）. Conclusion There is high safety of no bone graft intraoperatively for Sanders type Ⅱ and type Ⅲ intra-articular calcaneal fractures with bone defects,which can achieve good clinical outcome.