撬拨复位辅助钢板固定治疗跟骨骨折的效果及关节功能恢复分析

Analysis of the effect of the reduction and auxiliary plate fixation on the treatment of calcaneal fracture and the recovery of joint function

目的探讨手法撬拨复位辅助外置锁定钢板固定手术治疗跟骨骨折的手术效果及对术后关节功能恢复的影响。方法选取接受手术的92例(92足)跟骨骨折患者,随机将其分为联合组及对照组,每组46例,其中联合组采用手法撬拨复位辅助外置锁定钢板固定术,对照组采用传统切开复位内固定术。结果联合组手术出血量、手术时间、X线曝光时间、术后引流量、住院时间均较对照组降低(P<0.05),联合组术后非负重下地时间、完全负重时间则与对照组近似(P>0.05)。两组患者术前、术后3月、术后6月的Bohler角、Gissane角测定值组间差异无统计学意义(P>0.05),但术后3月、术后6月均较术前升高(P<0.05)。两组患者术后3月、术后6月的Hawkins评分组间差异无显著性(P>0.05),但术后6月均较术后3月升高(P<0.05)。联合组手术并发症率显著低于对照组(P<0.05)。结论手法撬拨复位辅助外置锁定钢板固定治疗跟骨骨折具有手术创伤更小、术后住院时间更少、并发症少的优势,同时保证了患者手术后的踝关节功能恢复。

Aim To explore the surgical effect of surgical manipulation and external locking plate fixation for the treatment of calcaneal fractures and the effect of postoperative joint function recovery.Methods 92 patients(92 feet)with calcaneal fractures were enrolled in our department.The patients were divided into the combined group and the control group by random number table.The combined group was treated with manual reduction and external fixation plate fixation.The patients were treated with traditional open reduction and internal fixation.Results The intraoperative blood loss,operation time,intraoperative X-ray irradiation time,drainage volume,hospitalization time and other indicators of the combined group were lower than those of the control group(P<0.05),the combined group’s postoperative non-weight bearing time and full weight bearing time were similar to the control group(P>0.05).There was no significant difference in the measured values of the Bohler angle and Gissane angle between the two groups before operation,3 months after operation,and 6 months after operation(P>0.05).However,3 months and 6 months after operation they were higher than those before operation(P<0.05),there was no significant difference in the Hawkins score between the two groups of patients at 3 months and 6 months after operation(P>0.05),but 6 months after operation were higher than 3 months after operation(P<0.05).The surgical complication rate of the combined group was significantly lower than that of the control group(P<0.05).Conclusion Manipulative reduction and assisted external locking plate fixation for the treatment of calcaneal fractures has the advantages of less surgical trauma,less postoperative hospital stay and fewer complications,and at the same time ensures the recovery of ankle function after surgery.