植骨与不植骨在手术治疗跟骨关节内骨折中的临床有效性研究

Clinical Efficacy of Bone Grafting and Non-grafting in the Surgical Treatment of Intra-articular Calcaneal Fractures

目的 探讨对跟骨关节内骨折患者分别采用植骨以及不植骨手术方法完成治疗后获得临床效果。方法 选取寿光市人民医院2018年1月—2020年12月收治的70例跟骨关节内骨折患者进行治疗研究;随机分为常规组(采用不植骨手术方法进行治疗)和研究组(采用植骨手术方法进行治疗),各35例;比较两组患者术后跟骨Bohler角、跟骨高度、跟骨Gissane角以及跟骨宽度。结果 研究组术后1个月跟骨Bohler角(26.45±2.15)°、术后3个月跟骨Bohler角(25.12±0.91)°以及术后12个月跟骨Bohler角(24.16±0.99)°均高于常规组,差异有统计学意义(t=6.737,11.760,22.156,P<0.05);研究组术后1个月跟骨高度(46.42±3.17)mm、术后3个月跟骨高度(45.26±1.02)mm以及术后12个月跟骨高度(44.75±1.39)mm均高于常规组,差异有统计学意义(P<0.05);研究组术后1个月跟骨Gissane角(131.91±9.49)°、术后3个月跟骨Gissane角(129.11±7.36)°、术后12个月跟骨Gissane角(128.69±5.59)°同常规组比较,差异无统计学意义(P>0.05);研究组术后1个月跟骨宽度(38.55±2.42)mm、术后3个月跟骨宽度(37.55±0.82)mm以及术后12个月跟骨宽度(37.16±1.17)mm同常规组术后1个月跟骨宽度(38.02±2.93)mm、术后3个月跟骨宽度(37.43±0.84)mm以及术后12个月跟骨宽度(37.26±0.99)mm比较,差异无统计学意义(P>0.05)。结论 植骨手术方法有效应用后,同不植骨手术方法比较,可减轻术后跟骨Bohler角丢失,有效改善跟骨高度,促进跟骨关节内骨折患者预后水平提高。

Objective To investigate the clinical effects of intra-articular fractures of the calcaneus after treatment with bone grafting and no bone grafting.Methods A total of 70 patients with intra-articular calcaneal fractures admitted to Shouguang People’s Hospital from January 2018 to December 2020 were selected for treatment research.They were randomly divided into conventional group(treatment without bone grafting) and study group(treatment with bone grafting),35 cases in each group.The Bohler angle of the calcaneus,the height of the calcaneus,the Gissane angle of the calcaneus and the width of the calcaneus were compared between the two groups after surgery.Results In the study group,the calcaneal Bohler angle was(26.45±2.15)° at 1 month after operation,(25.12±0.91)° at 3months after operation,and(24.16±0.99)° at 12 months after operation were higher than those of the conventional group,the difference was statistically significant(t =6.737,11.760,22.156,P <0.05).The calcaneal height of the study group was(46.42 ±3.17)mm at 1 month after operation,(45.26 ±1.02)mm at 3 months after operation,and(44.75±1.39) mm at 12 months after operation group,the difference was statistically significant(P <0.05).In the study group,the calcaneal Gissane angle was(131.91±9.49)° at 1 month after operation,(129.11±7.36)° at 3 months after operation,and(128.69±5.59)° at 12 months after operation,compared with the conventional group,the difference was not statistically significant(P >0.05).The calcaneal width of the study group was(38.55 ±2.42)mm at 1month after operation,(37.55±0.82)mm at 3 months after operation,and(37.16±1.17)mm at 12 months after operation,compared with the conventional group in the calcaneus width at 1 month after operation(38.02 ±2.93)mm,3months after operation(37.43±0.84)mm and 12 months after operation(37.26±0.99)mm,the difference was not statistically significant(P>0.05).Conclusion After the effective application of bone grafting surgery,compared with the surgical method without bone grafting,the loss of Bohler angle of the calcaneus can be reduced,the height of the calcaneus can be effectively improved,and the prognosis of patients with intra-articular calcaneal fractures can be improved.