术后跟骨螺钉取出的影响因素分析

Analysis of Influencing Factors of Calcaneal Screw Removal after Operation

目的:探讨术后跟骨螺钉取出的相关影响因素。方法:回顾性分析2015年1月—2016年12月在天津市天津医院进行各种足踝手术需要跟骨螺钉固定的患者118例,其中男61例,女57例。平均年龄(53.0±7.0)岁,平均体质指数(26.0±5.0)kg/m^2。比较不同临床特征患者的螺钉取出情况,将本组患者分为小螺钉组(螺钉长度≤6.5 mm)58例,大螺钉组(螺钉长度>6.5 mm)60例,比较两组的螺钉取出比例。结果:随访2年,共取出14个螺钉,其中炎性关节炎的螺钉取出率达37.5%(3/8),高于无炎性关节炎者的10.0%(11/110),差异有统计学意义(χ^2=4.645,P<0.05)。大、小螺钉组患者的螺钉取出比例(13.8%vs 11.7%),差异无统计学意义(χ^2=1.572,P>0.05)。结论:对于患有炎性关节炎的患者,应谨慎使用跟骨螺钉。使用较小直径的跟骨螺钉可能更能降低由于足跟疼痛导致的螺钉取出率。

Objective This paper discuss the related factors of calcaneal screw removal after operation.Methods A retrospective study of adult patients requiring calcaneal screw fixation from January 2015 to December 2016 was performed.We reviewed medical records and X-rays to assess factors related to screw removal.This study included 118 patients,which including 61 male patients and 57 female patients.The average age was(53.0±7.0)years and the average body mass index was(26.0±5.0)kg/m^2.Results During the 2-year follow-up,a total of 14 screws were removed.Among them,the screw removal rate of inflammatory arthritis reached 37.5%,which was higher than that of those without inflammatory arthritis.The difference was statistically significant(P<0.05).However,there was no significant difference in the screw removal ratio of patients with different screw diameters(P>0.05).Conclusion For patients with inflammatory arthritis,calcaneal screws should be used with caution.The use of smaller diameter calcaneal screws may be more effective in reducing the rate of screw removal due to heel pain.