粉碎性跟骨骨折术后患者应用便调式足踝固定装置的效果

Effect of Adjustable Foot and Ankle Fixture in Postoperative Patients with Comminuted Calcaneal Fracture

目的分析粉碎性跟骨骨折术后患者应用便调式足踝固定装置的短期效果。方法选取2019年1月至2020年6月医院收治的104例粉碎性跟骨骨折术后患者,随机分为对照组和观察组,各52例。对照组采用常规足踝固定装置固定,观察组采用便调式足踝固定装置固定,比较两组恢复情况、骨折恢复参数、骨代谢指标[骨碱性磷酸酶(BALP)、Ⅰ型前胶原氨基末端前肽(PINP)、Ⅰ型胶原交联羧基末端肽(CTX)]、炎症指标[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-22(IL-22)]、临床疗效及并发症发生率。结果观察组住院时间、下床活动时间、骨折愈合时间均短于对照组,术后7 d美国足踝外科协会(AOFAS)踝-后足评分高于对照组,差异有统计学意义(P<0.05);干预后,观察组跟骨结节关节角(Bohler角)、跟骨交叉角(Gissane角)及跟骨密度均高于对照组,差异有统计学意义(P<0.05);干预前、后,两组BALP、PINP、CTX比较,差异均无统计学意义(P>0.05);干预后,观察组IL-1β、IL-6及IL-22水平均低于对照组,差异有统计学意义(P<0.05);观察组护理优良率高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论粉碎性跟骨骨折术后患者应用便调式足踝固定装置能够促进其康复,且并发症发生率低。

Objective The short-term effect of adjustable foot and ankle fixture in postoperative patients with comminuted calcaneal fracture was analyzed.Methods From January 2019 to June 2020,104 postoperative patients with comminuted calcaneal fracture in the hospital were selected and divided into a control group and an observation group,with 52 patients in each group.The conventional foot and ankle fixture was used in the control group,while the adjustable foot and ankle fixture was used in the observation group,the recovery status,fracture recovery parameters,bone metabolism indicators[bone alkaline phosphatase(BALP),N-terminal propeptide of typeⅠprecollagen(PINP),typeⅠcollagecross-linked-telopeptide(CTX)],inflammatory indicators[interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-22(IL-22)],clinical effect,and incidence of complications were compared between the two groups.Results The length of hospital stay,time of getting out of bed and time of fracture healing of the observation group were all shorter than those of the control group,and the American Orthopaedic Foot and Ankle Society(AOFAS)foot and hindfoot scores 7 d after operation of the observation group was higher than that of the control group, with statistically significant differences (P<0.05);after intervention, the calcaneal tuberosity joint angle (Bohler's angle), calcaneus intersection angle (Gissane angle) and calcaneal bone density of the observation group were all higher than those of the control group, and calcaneal bone density, with statistically significant differences (P<0.05);before and after intervention, there was no statistically significant difference in BALP, PINP, CTX between the two groups (P>0.05);after intervention, the levels of IL- 1β, IL-6 and IL-22 of the observation group were all lower than those of the control group, with statistically significant differences (P<0.05);the excellent and good rate of the observation group was higher than that of the control group, with statistically significant difference (P<0.05);and the incidence of complications of the observation group was lower than that of the control group, with statistically significant difference (P<0.05). Conclusion The application of adjustable foot and ankle fixture in postoperative patients with comminuted calcaneal fracture can promote the recovery of patients, and the incidence of complications is relatively low.