应用Y形钢板治疗跟骨关节内骨折疗效的探讨

Effect of Y-shape plate in treating intra-articular calcaneal fractures

目的 探讨应用Y形钢板内固定术治疗跟骨关节内骨折患者的临床疗效及对患者运动功能的影响。方法 选取广西贺州市人民医院创伤骨科收治的跟骨关节内骨折患者45例(49足)作为研究对象。纳入标准:经CT、X线片等临床检查确诊为跟骨关节内骨折。排除标准:患有精神疾病、依从性差,无法配合治疗,病理性骨折的患者。入选时间为2016年3月至2018年3月,应用Y形钢板内固定术对患者进行治疗,总结患者的手术前、后的跟骨结节关节角(Bohler角)、跟骨交叉角(Gissane角)以及根据Maryland足部评分系统评价的足部运动功能的改善情况。采用SPSS 17.0统计学软件进行统计学分析,计量资料组间比较采用 t 检验。结果 治疗后的Gissane角、Bohler角、跟骨的高度均明显优于治疗前( t =10.45、11.56以及10.54,均 P <0.05);术后1年,患者的足部功能优良率77.8%。结论 应用Y形钢板内固定手术对跟骨关节内骨折患者进行治疗,能够促进患者足部运动功能的恢复,治疗效果较为理想,值得在临床上进一步推广应用。

Objective To study and analyze the clinical effect of Y plate internal fixation on patients with internal calcaneal fractures and its effect on patients’ motor function.Methods A total of 45 cases (49 feet) of intra-articular calcaneal fractures in Department of Trauma and Orthopedics of Hezhou People’s Hospital were recruited.Inclusion criteria:CT or X-ray films are diagnosed as intra-articular fractures of the calcaneus.Exclusion criteria:the patients with mental illness,poor compliance,unable to cooperate with treatment,pathological fractures.The time was from March 2016 to March 2018.The Y-shaped plate was used to treat patients.The calcaneal tubercle joint angle (angle of Bohler),calcaneal crossing angle (Gissane angle),and foot movement functions before and after surgery were measured and compared.The data were analyzed by t test.Results After the treatment,Gissane angle,Bohler angle,the height of the heel bone,were significantly better than the data before the treatment ( t =10.45,11.56,10.54,all P<0.05).After one year of treatment,the excellent and good rate of subtalar joint in the study group was 77.8%.Conclusion Application of Y-shaped plate internal fixation surgery to treat patients with intra-articular calcaneal fractures can promote patients foot motor function recovery,treatment effect is more ideal,worthy of further popularization and application in clinic.