关节面支撑型跟骨锁定板的设计及临床应用

Design and clinical application of articular surface supported calcaneal locking plate

目的 设计一种有效固定跟骨后距关节面的新型锁定钢板,并与普通锁定钢板比较以评价其疗效。方法 回顾性分析70例跟骨骨折患者资料。依据治疗方式的不同分为观察组(新型锁定钢板)36例和对照组(普通锁定钢板)34例。比较2组患者手术时间、术中出血量、住院时间、骨折愈合时间、部分负重时间、术后并发症发生率、Bolher角、Gissane角。采用美国足踝外科协会(AOFAS)踝-后足评分标准评估患足术后功能恢复情况。结果 所有患者随访时间12~15个月,平均(13.44±1.05)个月。术后切口相关并发症为对照组2例,观察组0例。观察组在手术时间、住院时间、骨折愈合时间、部分负重时间、术后并发症发生率、术后6个月及末次随访时Bolher角、Gissane角、AOFAS评分优良率方面表现均优于对照组,差异有统计学意义(P<0.05);2组术前和术后即刻Bolher角、Gissane角及术中出血量差异无统计学意义(P>0.05)。结论 新型锁定钢板构思合理,设计科学,术中操作简便,术后并发症少,在治疗跟骨骨折方面较普通锁定钢板有显著优势。

Objective To design a new type of locking plate for effective fixation of the posterior talar surface of calcaneal bone,and to compare with ordinary locking plate to evaluate its therapeutic effect.Methods The materials of 70 patients with calcaneal fracture were retrospectively analyzed.According to the different treatment methods,the patients were divided into observation group with 36 cases(treated with new type locking plate)and control group with 34 cases(treated with common locking plate).Operation time,intraoperative blood loss,length of hospital stay,fracture healing time,partial weight bearing time,incidence of postoperative complications,Bolher angle and Gissane angle were compared between the two groups.Ankle-hind foot scoring criteria of the American Orthopedic Foot Ankle Society(AOFAS)was used to evaluate postoperative functional recovery of affected foot.Results All the patients were followed up for 12 to 15 months,with an average of(13.44±1.05)months.There were 2 cases of postoperative incision-related complications in the control group and no case occurred complications in the observation group.In the observation group,operation time,hospital stay,fracture healing time,partial weight bearing time,incidence of postoperative complications as well as Bolher angle,Gissane angle and excellence rate of AOFAS score at 6 months and the last follow-up were significantly better than those in the control group(P<0.05);there were no significant differences in Bolher angle and Gissane angle before operation and immediately after operation as well as intraoperative blood loss between two groups(P>0.05).Conclusion The new type locking plate has advantages such as reasonable concept,scientific design,simple intraoperative operation and fewer postoperative complications,which is significantly better than ordinary locking plate in the treatment of calcaneal fractures.