闭合复位与钢板内固定治疗跟骨骨折的临床效果比较

Clinical comparison of closed reduction and plate internal fixation for the treatment of calcaneal fractures

目的分析跟骨骨折患者采用闭合复位与钢板内固定治疗的临床效果。方法选取2014年1月至2016年1月我院收治的106例跟骨骨折患者为研究对象,随机分为对照组与观察组各53例。对照组患者采用闭合撬拨复位外固定术治疗,观察组患者给予切开复位钢板内固定术治疗,比较两组患者的手术情况与术后恢复程度。结果对照组患者的手术时间、术中出血量与并发症发生率均明显优于观察组患者,差异有统计学意义(P<0.05)。观察组Ⅳ型患者的跟骨高度、Gissane角与Bohler角显著大于对照组患者,跟骨宽度显著小于对照组患者,差异有统计学意义(P<0.05)。观察组Ⅳ型Sanders分型患者的临床优良率77.8%,明显高于对照组同类型患者的临床优良率25.0%,差异有统计学意义(Z=-2.009,P=0.045)。结论闭合复位外固定与切开复位钢板内固定在跟骨骨折患者中均有良好应用价值,SandersⅡ型与Ⅲ型患者尽量采用闭合复位治疗,Ⅳ型患者尽早给予切开复位钢板内固定术。

Objective To analysis the clinical effects of closed reduction and plate internal fixation for the treatment of calcaneal fractures.Methods 106 patients with calcaneal fracture were selected in our hospital from January 2014 to January 2016. The patients were divided into the control group and the observation group, each group containing 53 cases. The patients in the control group were treated with poking closed reduction and external fixation, and the patients in the observation group were treated with open reduction and plate internal fixation. The operation conditions and degree of postoperative recovery in two groups were compared.Results The operation time, blood loss and complications in the control group were significantly better than those in observation group （P〈0.05）. The calcaneal height, Gissane angle and Bohler angle of type IV calcaneal fracture patients in the observation group were significantly larger than those in control group, but the calcaneal width was less than the control group （P〈0. 05 ）. The excellent rate of type IV calcaneal fracture patients in the observation group were significantly better than that in the control group （77.8% vs 25%, Z =- 2.009, P = 0.045）. Conclusions There are good application value of poking closed reduction and plate internal fixation for patients with calcaneal fractures. The patients with type Sanders II and III calcaneal fractures need to be treated with closed reduction, and patients with type IV calcaneal fractures should received open reduction and plate internal fixation as early as possible.