| 撬拨复位拉力螺钉内固定与小切口复位接骨板内固定治疗跟骨骨折的病例对照研究 |
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投稿时间：2018-12-03
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| 作者 | Author | 单位 | Address | E-Mail |
| 王亮 |
WANG Liang |
宁波大学医学院附属医院关节外科, 浙江 宁波 315000 |
Department of Joint Surgery, the Affiliated Hospital of Medical College of Ningbo University, Ningbo 315000, Zhejiang, China |
wangliang1983123@163.com |
| 叶如卿 |
YE Ru qing |
宁波大学医学院附属医院关节外科, 浙江 宁波 315000 |
Department of Joint Surgery, the Affiliated Hospital of Medical College of Ningbo University, Ningbo 315000, Zhejiang, China |
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| 王猛 |
WANG Meng |
宁波大学医学院附属医院关节外科, 浙江 宁波 315000 |
Department of Joint Surgery, the Affiliated Hospital of Medical College of Ningbo University, Ningbo 315000, Zhejiang, China |
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| 期刊信息：《中国骨伤》2019年，第32卷，第4期，第314-320页 |
| DOI：10.3969/j.issn.1003-0034.2019.04.005 |
| 基金项目: |
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中文摘要:
目的：比较单纯撬拨复位拉力螺钉内固定与小切口复位接骨板内固定治疗跟骨骨折的临床疗效。
方法：回顾性分析2015年6月至2018年6月收治的88例（98足）跟骨骨折患者的临床资料。根据骨折分型及治疗方法不同分为撬拨复位拉力螺钉内固定术组（A组）50例，男32例，女18例；年龄（32.6±6.7）岁；SandersⅡ-Ⅲ型30例，Sanders Ⅳ型20例。小切口复位接骨板内固定术组（B组）48例，男30例，女18例；年龄（31.9±7.2）岁；SandersⅡ-Ⅲ型28例，Sanders Ⅳ型20例。分别于术前、术后1个月及1年比较两组患者的Böhler角、Gissane角及AOFAS评分以评价其临床疗效。
结果：所有患者获得随访，时间13~24（14.6±6.3）个月。术后两组Böhler角、Gissane角及AOFAS评分均得到不同程度改善。对于SandersⅡ-Ⅲ型患者，两组术前、术后1个月及1年Böhler角、Gissane角比较差异无统计学意义；术后1年AOFAS评分比较差异无统计学意义。对于Sanders Ⅳ型患者，B组术后1个月、1年时Böhler角[（35.40±1.85）°、（35.15±1.90）°]和Gissane角[（127.80±5.49）°、（127.00±3.06）°]高于A组Böhler角[（27.85±3.42）°、（27.25±1.80）°]和Gissane角[（118.00±4.13）°、（117.50±5.04）°]（P<0.05）；两组术后1个月、1年时Böhler角、Gissane角均较术前提高（P<0.05）；B组术后1年AOFAS评分91.00±5.46高于A组84.50±4.64（P<0.05）。
结论：对于SandersⅡ-Ⅲ型中度跟骨骨折，两种治疗方法疗效相当；但对于Sanders Ⅳ型重度跟骨骨折，与撬拨复位拉力螺钉内固定术相比，小切口复位接骨板内固定术可获得更好的复位和可靠固定，改善患足功能。 |
| 【关键词】跟骨 骨折 骨折固定术 病例对照研究 |
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| Case-control study on poking closed reduction cannulated screw fixation and small incision reduction plate fixation for the treatment of calcaneal fractures |
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ABSTRACT
Objective:To compare poking closed reduction cannulated screw fixation and small incision reduction plate fixation in treating calcaneal fractures.
Methods:Clinical data of 98 patients with calcaneal fractures were retrospectively analyzed from June 2015 and June 2018. According to fracture classification and treatment methods,the patients were divided into poking closed reduction cannulated screw fixation (group A) and small incision reduction plate fixation(group B). In group A,there were 50 patients,including 32 males and 18 females with an average of (32.6±6.7) years old;30 patients were classified to type Sanders Ⅱ-Ⅲ and 20 patients were type Sanders Ⅳ;treated with poking closed reduction cannulated screw fixation. While in group B,there were 48 patients,including 30 males and 18 females with an average of (31.9±7.2) years old;28 patients were classified to type Sanders Ⅱ-Ⅲ and 20 patients were type Sanders Ⅳ;treated with small incision reduction plate fixation. Böhler angle,Gissane angle and AOFAS scores were compared between two groups before operation and 1 month,1 year after operation.
Results:All patients were followed up for 13 to 24 months with an average of (14.6±6.3) months. Böhler angle,Gissane angles and AOFAS score between two groups were improved at different degrees after operation. For Sanders Ⅱ and Ⅲ patients,there were no statistical differences in Böhler angle,Gissane angle between two groups before operation,1 month and 1 year after operation;and there was no differences in AOFAS score between two groups at 1 year after operation. For Sanders Ⅳ patients,Böhler angle[(35.40±1.85) °,(35.15±1.90) °] and Gissane angles[(127.80±5.49) °,(127.00±3.06) °] in group B were higher than that of group A[(27.85±3.42) °,(27.25±1.80) ° and (118.00±4.13) °,(117.50±5.04) °] at 1 month and 1 year after operation(P<0.05);Böhler angle and Gissane angle at 1 month and 1 year after operation between two groups were improved higher than before operation(P<0.05);AOFAS score in group B (91.00±5.46) was higher than that of group A (84.50±4.64) (P<0.05).
Conclusion:For SandersⅡ-Ⅲ calcaneal fractures,the two treatment methods have the equivalent effect. While for Sanders Ⅳ patients,small incision reduction plate fixation has better reduction,stable fixation and could improve foot function compared with poking closed reduction cannulated screw fixation. |
| KEY WORDS Calcaneus Fracture Fracture fixation Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王亮,叶如卿,王猛.撬拨复位拉力螺钉内固定与小切口复位接骨板内固定治疗跟骨骨折的病例对照研究[J].中国骨伤,2019,32(4):314~320 |
| 英文格式: | WANG Liang,YE Ru qing,WANG Meng.Case-control study on poking closed reduction cannulated screw fixation and small incision reduction plate fixation for the treatment of calcaneal fractures[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(4):314~320 |
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