小切口解剖钢板联合加压螺栓治疗跟骨关节内骨折临床效果研究

Clinical effect of small-incision anatomical plate and compression bolts on intra-articular calcaneal fracture

目的探讨小切口解剖钢板联合加压螺栓微创治疗跟骨关节内骨折的疗效。方法回顾性选取2011年11月至2014年8月于解放军第一○五医院诊治的75例(82足)跟骨关节内骨折患者进行研究,依据治疗方法分为研究组(38例,41足)和对照组(37例,41足),所有患者均知情同意。对照组实施传统手术治疗,研究组行小切口解剖钢板和加压螺栓联合治疗。比较2组患者围手术期指标(切口长度、手术时间、术后负重时间),治疗前后跟骨情况(Gissane角、Bohler角、长度、宽度、高度),跟骨功能及术后并发症情况。结果研究组患者的手术切口、手术时间、术后负重时间均较对照组短(P<0.05)。2组患者治疗后跟骨Gissane角、Bohler角、长度、宽度、高度均较治疗前明显改善,且研究组较对照组改善更明显,差异有统计学意义(P<0.05)。研究组和对照组的治疗优良率分别为75.61%和51.22%,并发症发生率分别为4.88%和31.71%,差异均有统计学意义(P<0.05)。结论小切口解剖钢板和加压螺栓联合治疗跟骨关节内骨折,患者足部损伤小,足功能恢复快,手术并发症少,效果显著,值得临床推广。

Objective To evaluate the clinical effect of small-incision anatomical plate and compression bolts on intra-articular calcaneal fracture. Methods Seventy-five patients（ 82 feet） with intra-articular calcaneal fracture treated in our hospital from November 2011 to August 2014 were enrolled in the retrospective study and the patients were divided into the study group（ 37 cases,41 feet） and the control group（ 36 cases,41 feet） by different treatment methods. The control group was treated with traditional surgical method,while the study group was treated by small-incision anatomical plate and compression bolts. Then,such perioperative indicators as length of incision,surgical time,weight load time,the calcaneal conditions before and after treatment（ Gissane angle,Bohler angle,length,width,height）,calcaneal function and complications after surgery were compared between the patients of the 2 groups. Results The surgical incision,surgical time and weight load time of the study group were all shorter than those of the control group（ P〈 0. 05）.After treatment,the Gissane angle,Bohler angle,length,width and height in the patients of the two groups were significantly improved as compared with those before treatment,and very significant differences could be seen in the study group,as compared with those of the control group（ P〈 0. 05）. Excellent cure rates of the study and control groups were respectively 75. 61% and 51. 22%,and complication rates of the study and control groups were respectively 4. 88% and 31. 71%. Statistical significance could be noted,when comparisons were made between them（ P〈 0. 05）. Conclusion The small incision anatomical plate plus compression bolts in the treatment of intra-articular calcaneal fracture had the feature of minor foot injury,faster foot function recovery,less surgical complications and better therapeutic effects. For this reason,it was worth further clinical promotion.