显微外科技术联合外固定支架在移位性跟骨关节内骨折中的应用效果

Application of microsurgical technique combined with external fixation in displaced intra-articular calcaneal fracture

目的：探讨显微外科技术联合外固定支架在移位性跟骨关节内骨折中的应用效果。方法：2011年1月～2016年1月选择在我院诊治的移位性跟骨关节内骨折患者60例，根据入院顺序分为观察组与对照组各30例，对照组给予显微外科手术治疗，观察组在对照组治疗的基础上在术后给予外固定支架治疗，观察两组预后与并发症发生情况。结果：所有患者都顺利完成手术，术中无严重并发症发生；观察组术后1个月的切口感染、骨髓炎、植入物疼痛、肌腱损伤等并发症发生情况明显少于对照组，所有并发症都对症处理后好转。观察组术后1个月跟骨Bohler角和Gissane角分别为30.59±4.33°和121.49±6.49°，而对照组分别为25.33±3.42°和125.39±7.13°，在组内与组间对比差异都有统计学意义。观察组与对照组术后1个月的优良率分别为93.3%和70.0%，观察组的优良率明显高于对照组。结论：显微外科技术联合外固定支架在移位性跟骨关节内骨折中的应用能促进Bohler角和Gissane角的恢复，减少术后并发症的发生，从而提高整体预后疗效，有很好的应用价值。

Objective To investigate the application effects of microsurgical technique combined with external fixation in displaced intra-articular calcaneal fracture. Methods From January 2011 to January 2016, 60 cases displaced intra-articular calcaneal fracture patients in our hospital were selected for treatment and were equally divided into observation group and con-trol group accorded to the order of admission, the control group were given the microsurgical treatment, the observation group were added the postoperative external fixation based on the control group, observed the prognosis and the incidences of com-plications in two group. Results All patients were successfully completed surgery and were without serious complications;The postoperative 1 month of complications incidences of wound infection, osteomyelitis, implantation pain and tendon injuries in the observation group were less than that of the control group, All the complications were symptomatic treatment after turn for the better. The postoperative 1 month of Bohler angle and gissane angle in the observation group were 30.59±4.33°and 121.49±6.49 °, while the control group were 25.33±3.42° and 125.39±7.13 ° that compared within group and between groups differences were all statistical significance . The postoperative 1 month of excellent rates in the observation group and the control group were 93.3%and 70%, the excellent rate of the observation group was significantly higher than the control group. Conclusion Microsurgical techniques combined with external fixation in displaced intra-articular calcaneal fractures can pro-mote recovery of Bohler angle and gissane angle, reduce the incidence of postoperative complications, so as to improve the over-all prognosis that has very good application values.