闭合复位经皮穿针内固定治疗Paley B1型跟骨骨折的临床疗效和安全性

Clinical efficacy and safety of closed reduction and percutaneous needle internal fixation in the treatment of Paley type B1 calcaneal fractures

目的探讨Paley B1型跟骨骨折采用闭合复位经皮穿针内固定治疗的临床效果。方法选取2014年5月至2017年5月我院168例Paley B1型跟骨骨折患者为研究对象,采用随机数字表法将其分为对照组和研究组,每组84例,对照组患者采用切开复位接骨板内固定治疗,研究组患者采用闭合复位经皮穿针内固定治疗,比较两组患者的手术情况、临床疗效及手术前、后Gissane、Bohler角变化情况。结果研究组患者的手术时间、术中出血量、住院时间及并发症总发生率均显著优于对照组(P<0.05);研究组治疗优良率为94.05%,显著高于对照组的80.95%(P<0.05)。随访6个月后,两组患者Gissane、Bohler角较术前均显著增大(P<0.05),两组比较,差异不显著(P>0.05)。结论闭合复位经皮穿针内固定可有效提高Paley B1型跟骨骨折的手术效果,缩短手术时间及治疗时间,且不影响Gissane、Bohler角水平,值得临床应用推广。

Objective To investigate the effect of closed reduction and percutaneous needle internal fixation in thetreatment of Paley type B1 calcaneal fractures. Methods From May 2014 to May 2017, 168 patients with Paley type B1calcaneus fracture in our hospital were selected as the research objects, and divided into control group and research groupaccording to random digital table method, with 84 cases in each group. The patients in the control group were treated withopen reduction and plate internal fixation, the patients in the research group were treated with closed reduction andpercutaneous internal fixation. The operation indicator, clinical effects, changes of Gissane and Bohler angle before andafter surgery between the two groups were compared. Results The operation time, amount of peroperative bleeding, hospitalstays and the total incidence of complications in the research group were significantly better than those of the control group（P〈0.05）. The excellence and good rate of treatment in the research group was 94.05%, which was higher than 80.95% inthe control group（P〈0.05）. After following-up for 6 months, the Gissane and Bohler angles of the patients in the two groupswere significantly higher than those before surgery（P〈0.05）, and there were no significant differences in which between thetwo groups（P〉0.05）. Conclusion Closed reduction and percutaneous internal fixation can effectively improve the operationeffect of Paley type B1 calcaneal fractures, shorten the operation time and treatment time, and does not affect the Gissaneand Bohler angles, which is worthy of clinical application and promotion.