锁定接骨板内固定治疗移位的关节内跟骨骨折的临床观察

Clinical Observation of Internal Fixation of Displaced Intra-articular Calcaneal Fractures with Locking Plate

目的:研究锁定接骨板内固定治疗移位的关节内跟骨骨折的临床效果。方法:选取2015年5月-2017年5月于笔者所在医院使用锁定接骨板内固定术治疗移位的关节内跟骨骨折患者53例作为研究对象,对患者的关节进行复位之后在跟骨外侧放置跟骨锁定接骨板,在手术前后对所有患者的Bohler角和Gissane角进行测量,评价患者的跟骨骨折复位情况,并对所有患者进行随访6~28个月。结果:在对患者进行随访的过程中,没有患者出现严重感染与皮肤坏死,患者的骨折愈合情况良好,平均愈合时间为(3.5±1.0)个月。在术后6个月对患者的骨折部位进行复查显示患者的Bohler角和Gissane角分别为(27.65±5.87)°和(124.93±7.42)°,与手术前的Bohler角和Gissane角对比差异有统计学意义(P<0.05)。所有患者在术后进行Maryland足部系统评分,恢复效果为优的患者有38例,恢复效果为良的患者有13例,恢复效果为差的患者有2例,患者治疗效果的优良率为96.22%。结论:使用锁定接骨板内固定对移位的关节内跟骨骨折患者进行治疗能够显著改善患者的Bohler角和Gissane角,术后的感染率与皮肤坏死率都非常低,治疗效果显著,值得在临床上进行广泛推广与应用。

Objective:To study the clinical effect of locking intra-articular intra-articular calcaneal fractures with internal fixation.Method:From May 2015 to May 2017,53 cases with displaced intra-articular calcaneal fractures in our hospital who used locking plate fixation were selected as the research object,to reset after the joints in patients with calcaneal locking plate was placed on the outside of calcaneal,Bohler Angle in all patients before,during,and after surgery and Gissane angle measurement,evaluation of patients with calcaneal fracture situation,and carries on all of the patients were followed up for 6-28 months.Result:No severe infection and skin necrosis occurred during the follow-up of the patients,the fracture healing of the patients was good,and the mean healing time was(3.5±1.0)months.6 months after surgery for patients with fracture position was reviewed according to the patient’s Bohler Angle and Gissane Angle(27.65±5.87)°and(124.93±7.42)°respectively,and compared with Bohler Angle and Gissane Angle of preoperative were significant difference(P<0.05).All of the patients after surgery for Maryland foot system score,38 cases of patients for optimal recovery effect,13 cases of patients recovery effect was good,the recovery effect of 2 cases of patients,patients with curative effect was 96.22%.Conclusion:The use of locking plate internal fixation for patients with displaced intraarticular calcaneal fractures treatment can significantly improve the patient's Bohler angle and Gissane angle,postoperative infection and skin necrosis rate is very low,treatment effect is remarkable,is worth popularization and application of extensively in clinical.