跟骨解剖板在累及跟距关节的粉碎性跟骨骨折中的应用价值(1)
【摘要】 目的：研究跟骨解剖板在累及跟距關节的粉碎性跟骨骨折中的应用价值。方法：选取2013年1月-2015年1月笔者所在医院收治的72例粉碎性跟骨骨折伴跟距关节损伤患者作为研究对象，采用随机数字表法将患者分为对照组和观察组，每组36例，对照组患者采取撬拨复位外固定支架加压固定治疗，观察组患者采取切开复位跟骨解剖板内固定治疗，比较两组的治疗优良率、足踝功能评分、并发症发生率、Bohler角、Gissane角、跟骨宽度。结果：观察组的治疗优良率为86.11%，与对照组的88.89%比较，差异无统计学意义(P>0.05)；治疗后，两组患者的AOFAS足踝功能评分均明显高于治疗前，比较差异均有统计学意义(P<0.05)，但观察组与对照组治疗后的AOFAS足踝功能评分比较差异无统计学意义(P>0.05)；观察组与对照组的并发症发生率分别为11.11%、8.33%，比较差异无统计学意义(P>0.05)；治疗后，两组患者的Bohler角、Gissane角、跟骨宽度均优于治疗前，比较差异均有统计学意义(P<0.05)，且观察组治疗后的Bohler角、Gissane角、跟骨宽度明显优于对照组治疗后，比较差异均有统计学意义(P<0.05)。结论：在累及跟距关节的粉碎性跟骨骨折患者中，采用跟骨解剖板内固定治疗可达到撬拨复位外固定支架加压固定治疗同等效果，其并发症较少，足踝功能可得到有效改善，改善患者的跟距关系及跟骨宽度。
【关键词】 粉碎性跟骨骨折； 跟距关节； 跟骨解剖板； 骨外科
doi：10.14033/j.cnki.cfmr.2018.9.006 文献标识码 A 文章编号 1674-6805(2018)09-0012-03
Application Value of Calcaneal Anatomical Plate in Treatment of Comminuted Calcaneal Fracture Involved Calcaneal-talus Joint/XU Guanwei，WANG Qing，GE Rui.//Chinese and Foreign Medical Research，2018，16(9)：12-14
【Abstract】 Objective：To study and discuss the clinical effect of calcaneal anatomical plate in the treatment of comminuted calcaneal fracture involved with calcaneal-talus joint.Method：From January 2013 to January 2015，72 cases of comminuted calcaneal fracture injury admitted to our hospital were selected as the research object.The patients were divided into control group and observation group by random number table method，with 36 cases in each group.The patients in the control group were treated with percutaneous reduction by leverage and external fixation.The patients in the observation group were treated with open reduction and calcaneal anatomical plate fixation.The excellent and good rates of ankle function，ankle function score，complication rate，Bohler angle，Gissane angle and calcaneus width were compared between the two groups.Result：The excellent and good rate of treatment in observation group was 86.11%，compared with the 88.89% of the control group，the difference was not statistically significant(P>0.05).After treatment，the AOFAS ankle function scores of both groups were significantly higher than those before the treatment，and the difference was statistically significant(P<0.05).However，there was no significant difference in AOFAS ankle function scores between the observation group and the control group after the treatment(P>0.05).The complication rates of the observation group and the control group were 11.11% and 8.33% respectively，with no significant difference(P>0.05).After treatment，the Bohler angle，Gissane angle and calcaneus width were all better to those before the treatment，and the difference was statistically significant(P<0.05)，and the Bohler angle，Gissane angle and calcaneus width in the observation group were significantly better than those in the control group，the difference was statistically significant (P<0.05).Conclusion：In patients with comminuted calcaneal fractures involved calcaneal-talus joint，the use of calcaneus anatomical plate internal fixation can achieve the same effect of percutaneous reduction by leverage and external fixation，reduction and external fixation with compression fixation，with fewer complications，and ankle function can be effectively improved.It can improve the patients’ heel relationship and calcaneus width., 百拇医药(许冠伟 王清 葛瑞)
【关键词】 粉碎性跟骨骨折； 跟距关节； 跟骨解剖板； 骨外科
doi：10.14033/j.cnki.cfmr.2018.9.006 文献标识码 A 文章编号 1674-6805(2018)09-0012-03
Application Value of Calcaneal Anatomical Plate in Treatment of Comminuted Calcaneal Fracture Involved Calcaneal-talus Joint/XU Guanwei，WANG Qing，GE Rui.//Chinese and Foreign Medical Research，2018，16(9)：12-14
【Abstract】 Objective：To study and discuss the clinical effect of calcaneal anatomical plate in the treatment of comminuted calcaneal fracture involved with calcaneal-talus joint.Method：From January 2013 to January 2015，72 cases of comminuted calcaneal fracture injury admitted to our hospital were selected as the research object.The patients were divided into control group and observation group by random number table method，with 36 cases in each group.The patients in the control group were treated with percutaneous reduction by leverage and external fixation.The patients in the observation group were treated with open reduction and calcaneal anatomical plate fixation.The excellent and good rates of ankle function，ankle function score，complication rate，Bohler angle，Gissane angle and calcaneus width were compared between the two groups.Result：The excellent and good rate of treatment in observation group was 86.11%，compared with the 88.89% of the control group，the difference was not statistically significant(P>0.05).After treatment，the AOFAS ankle function scores of both groups were significantly higher than those before the treatment，and the difference was statistically significant(P<0.05).However，there was no significant difference in AOFAS ankle function scores between the observation group and the control group after the treatment(P>0.05).The complication rates of the observation group and the control group were 11.11% and 8.33% respectively，with no significant difference(P>0.05).After treatment，the Bohler angle，Gissane angle and calcaneus width were all better to those before the treatment，and the difference was statistically significant(P<0.05)，and the Bohler angle，Gissane angle and calcaneus width in the observation group were significantly better than those in the control group，the difference was statistically significant (P<0.05).Conclusion：In patients with comminuted calcaneal fractures involved calcaneal-talus joint，the use of calcaneus anatomical plate internal fixation can achieve the same effect of percutaneous reduction by leverage and external fixation，reduction and external fixation with compression fixation，with fewer complications，and ankle function can be effectively improved.It can improve the patients’ heel relationship and calcaneus width., 百拇医药(许冠伟 王清 葛瑞)