跟骨牵引复位控制装置辅助治疗跟骨骨折中长期疗效观察

Long-term therapeutic effect of homemade device for treatment of calcaneus fracture

目的探讨总结使用已获得专利的跟骨牵引复位控制装置在跟骨骨折手术中辅助治疗的可行性及其临床疗效。方法本文分析2014年1月至2016年8月期间在常州市第一人民医院骨科收治的40例41足跟骨骨折患者。观察组20例21足跟骨骨折采用获得专利的跟骨牵引复位控制装置辅助复位,而后使用锁定钢板固定;对照组20例20足采用传统的切开复位内固定方法。术后、术后1年及术后5年随访时行患足影像学检查,在影像学资料上按照比例尺测量跟骨的长度、宽度、高度、Bohler角及Gissane角,同时采用Maryland Foot Score、AOFAS及VAS评分系统对患足进行评分。结果本研究中40例患者中有39例患者40足获得术后5年规律随访,1例患者因为个人原因失访。观察组和对照组的影像学与功能学指标与术前相比明显改善。末次随访时观察组各项指标与对照组相比差异有统计学意义。随访期间未发现切口感染,皮瓣坏死等手术相关并发症。结论跟骨骨折手术中使用跟骨牵引复位控制装置辅助复位,操作方便,效果确切。使用跟骨牵引复位控制装置辅助治疗跟骨骨折值得在临床应用中推广。

Objective To study the feasibility and clinical efficacy of homemade device(calcaneal traction and reduction control)in the adjuvant calcaneal fracture therapy for surgical treatment.Methods 40 calcaneal fracture patients(41 feet)were collected from January 2014 to August 2016 in Changzhou first people′s hospital.20 patients(21 feet)were treated with adjuvant homemade device(experiment group),and other patients were treated with traditional method(control group).According to the radiographic criterion,the plantar imaging examination was followed up.Meanwhile,the postoperative function was evaluated by Maryland Foot Score system,AOFAS and VAS soccer.Results 39 patients(40 feet)were successfully followed up for five years.They all acquired almost normal calcaneus length,height,width,Bohler angle and Gissane angle one year after surgery.And they also have significantly improved Maryland Foot Score,AOFAS score and VAS score one year after surgery compared with pre-operation.The difference of calcaneus length,height,width,Bohler angle,Gissane angle,Maryland Foot Score,and AOFAS score were significance different between experimental group and control group after five years surgery(P<0.05).No patients had incision healing delay or wound infection after surgery.Conclusion The homemade device(calcaneal traction and reduction control)can restore bone length,height,width and calcaneal axis after calcaneal fracture surgery,which is worth popularizing in the clinical treatment.