分期手术治疗Gustilo Ⅱ、ⅢA型开放性跟骨骨折的临床研究(1)
[摘要] 目的 探析对Gustilo Ⅱ、ⅢA型开放性跟骨骨折患者采用分期手术治疗的效果及安全性。方法 随机选取该院于2016年4月—2018年5月收治的60例Gustilo Ⅱ、ⅢA型开放性跟骨骨折患者，将其分为对照组与观察组，各组30例。其中对照组采用常规手术治疗方式，观察组则采取分期手术治疗。之后对比两组患者的临床疗效、并发症发生情况以及AOFAS的评分情况。 结果 观察组通过分期手术治疗，患者的临床治疗总有效率为83.3%，对照组在常规手术治疗下，临床治疗总有效率则为56.6%，两组相较差异有统计学意义(χ2=3.888 9，P=0.0486);观察组术后并发症发生率为16.7%，对照组的则为46.7%，差异有统计学意义(χ2=4.929 4，P=0.026 4);觀察组术后AOFAS评分中疼痛评分(23.9±5.4)分、功能评分为(39.2±5.7)分、后足力线评分为(8.5±1.4)分，对照组则分别为(29.7±4.6)分、(33.6±5.3)分、(7.3±1.6)分，两组相较差异有统计学意义(P<0.05)。结论 针对Gustilo Ⅱ、ⅢA型开放性跟骨骨折患者的治疗过程中，给予患者分期手术的治疗方式，不仅能显著提高患者的治疗效率，降低并发症发生率，还可优化患者术后各项功能评分，值得临床借鉴实施。
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[关键词] 跟骨骨折;开放性骨折;分期手术;软组织;闭合复位
[中图分类号] R687 [文献标识码] A [文章编号] 1674-0742(2019)08(b)-0060-03
[Abstract] Objective To evaluate the efficacy and safety of staged surgery for patients with Gustilo II and IIIA open calcaneal fractures. Methods Sixty patients with open calcaneus fractures of Gustilo type II and IIIA who were admitted to our hospital from April 2016 to May 2018 were randomly selected and divided into control group and observation group， 30 cases in each group. The control group was treated with conventional surgery， and the observation group was treated with staged surgery. The clinical efficacy， complications， and AOFAS scores were compared between the two groups. Results The observation group was treated with staging surgery. The total effective rate of clinical treatment was 83.3%. In the control group， the total effective rate of clinical treatment was 56.6%. The difference between the two groups was statistically significant(χ2=3.888 9， P=0.048 6); the incidence of postoperative complications was 16.7% in the observation group and 46.7% in the control group， the difference was statistically significant(χ2=4.929 4， P=0.026 4); the pain score in the AOFAS score of the observation group (23.9±5.4)points. The functional score was (39.2±5.7)points， the posterior foot force score was (8.5±1.4)points， and the control group was (29.7±4.6)points， (33.6±5.3)points， (7.3±1.6)points， respectively. The difference was statistically significant(P<0.05). Conclusion In the treatment of patients with Gustilo II and IIIA open calcaneal fractures， the treatment of patients with staged surgery can not only significantly improve the treatment efficiency， reduce the incidence of complications， but also optimize the postoperative functional scoring， which is worthy of clinical implementation.
[Key words] Calcaneal fracture; Open fracture; Staging surgery; Soft tissue; Closed reduction, 百拇医药(温文伟)
, http://www.100md.com
[关键词] 跟骨骨折;开放性骨折;分期手术;软组织;闭合复位
[中图分类号] R687 [文献标识码] A [文章编号] 1674-0742(2019)08(b)-0060-03
[Abstract] Objective To evaluate the efficacy and safety of staged surgery for patients with Gustilo II and IIIA open calcaneal fractures. Methods Sixty patients with open calcaneus fractures of Gustilo type II and IIIA who were admitted to our hospital from April 2016 to May 2018 were randomly selected and divided into control group and observation group， 30 cases in each group. The control group was treated with conventional surgery， and the observation group was treated with staged surgery. The clinical efficacy， complications， and AOFAS scores were compared between the two groups. Results The observation group was treated with staging surgery. The total effective rate of clinical treatment was 83.3%. In the control group， the total effective rate of clinical treatment was 56.6%. The difference between the two groups was statistically significant(χ2=3.888 9， P=0.048 6); the incidence of postoperative complications was 16.7% in the observation group and 46.7% in the control group， the difference was statistically significant(χ2=4.929 4， P=0.026 4); the pain score in the AOFAS score of the observation group (23.9±5.4)points. The functional score was (39.2±5.7)points， the posterior foot force score was (8.5±1.4)points， and the control group was (29.7±4.6)points， (33.6±5.3)points， (7.3±1.6)points， respectively. The difference was statistically significant(P<0.05). Conclusion In the treatment of patients with Gustilo II and IIIA open calcaneal fractures， the treatment of patients with staged surgery can not only significantly improve the treatment efficiency， reduce the incidence of complications， but also optimize the postoperative functional scoring， which is worthy of clinical implementation.
[Key words] Calcaneal fracture; Open fracture; Staging surgery; Soft tissue; Closed reduction, 百拇医药(温文伟)