| 人工骨和自体骨在复杂跟骨骨折异形钢板内固定术中的病例对照研究 |
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Received:December 18, 2020
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| 期刊信息：《中国骨伤》2021年34卷，第9期，第808-813页 |
| DOI：10.12200/j.issn.1003-0034.2021.09.004 |
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目的：比较人工骨与自体骨在复杂跟骨骨折异形钢板内固定术中的临床疗效。
方法：自2015年4月至2019年4月收治60例复杂跟骨骨折患者行切开复位异形钢板内固定术治疗，按照植骨材料不同分为试验组和对照组，每组30例。试验组男21例，女9例；年龄18~71（36.85±7.42）岁；Sanders Ⅲ型19例，Sanders Ⅳ型11例；采用人工骨植入。对照组男23例，女7例，年龄20~69（37.26±7.38）岁；Sanders Ⅲ型18例，Sanders Ⅳ型12例；采用自体骨植入。比较两组患者手术时间、术中出血量、术后切口干燥时间、愈合时间及并发症情况，比较术前及术后3个月Böhler角及Gissane角变化情况，采用Maryland评分评价患足功能恢复情况。
结果：两组患者术后均获得随访，时间3~15（10.15±2.67）个月。试验组手术时间、术中出血量分别为（89.32±12.43） min、（101.64±5.13） ml，对照组分别为（112.45±13.82） min、（119.01±5.26） ml，两组比较差异有统计学意义（P<0.05）；两组术后切口干燥时间、愈合时间、并发症比较差异无统计学意义（P>0.05）。试验组术前、术后3个月Böhler角分别为（14.19±2.47）°、（34.52±4.41）°，对照组分别为（14.08±2.35）°、（33.67±4.36）°；试验组术前及术后3个月Gissane角分别为（90.16±6.43）°、（131.45±9.83）°，对照组分别为（90.11±6.37）°、（130.87±9.24）°；两组术后3个月Böhler角、Gissane角与术前比较差异有统计学意义（P<0.05）；但两组术后3个月Böhler角、Gissane角比较差异无统计学意义（P>0.05）。末次随访时，两组Maryland评分各项目评分、总分及优良率比较差异无统计学意义（P>0.05）。
结论：在复杂跟骨骨折异形钢板内固定术中，采用人工骨和自体骨在促进骨折恢复方面效果相当，且术后切口干燥时间、愈合时间及并发症发生情况相近，但使用人工骨可减少术中出血量，缩短手术时间。 |
| [关键词]:跟骨 骨折固定术,内 骨折切开复位 病例对照研究 |
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| Case-control study on the application of artificial bone and autogenous bone in internal fixation of complex calcaneal fracture with special-shaped plate |
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Abstract:
Objective: To compare clinical effects of artificial bone and autogenous bone in internal fixation of complex calcaneal fracture with profitated plate.
Methods: From April 2015 to April 2019,60 patients with complex calcaneal fractures were treated with open reduction and heteromorphic plate internal fixation,and were divided into experiment group and control group by implant bone substitutes,and 30 patients in each group. In experiment group,there were 21 males and 9 females aged from 18 to 71 years old with an average of (36.85±7.42) years old;19 patients were classified to type Ⅲ and 11 patients were type Ⅳ according to Sanders classification;implanted with artificial bone. While in control group,there were 23 males and 7 females aged from 20 to 69 years old with an average of (37.26±7.38) years old;18 patients were classified to type Ⅲ and 12 patients were type Ⅳ according to Sanders classification; implanted with autogenous bone. Operation time,intraoperative blood loss,drying time of incision,fracture healing time and complications were compared between two groups,changes of preoperative and postoperative Böhler angle and Gissane angle were also compared,and Maryland scoring was applied to evaluate recovery of affected foot.
Results: Both of two groups were followed up from 3 to 15 months with an average of (10.15±2.67) months. Operation time and intraoperative blood loss in experiment group were(89.32±12.43) min,(101.64±5.13) ml,respectively;while in control group were(112.45±13.82) min,(119.01±5.26) ml,respectively;and there were statistical difference between two groups(P<0.05). There were no differences in drying time of incision,fracture healing time and complications between two groups(P>0.05). Preoperative and postoperative Böhler angle at 3 months in experiment group were (14.19±2.47)°,(34.52±4.41)°;while in control group were (14.08±2.35)°,(33.67±4.36)°;preoperative and postoperative Gissane angel at 3 months in experiment group were(90.16±6.43)°,(131.45±9.83)°;while in control group were (90.11±6.37)°,(130.87±9.24)°;there were statistical significance in Böhler angle and Gissane angel compared with 3 months after operation and before operation between two groups(P<0.05);while no difference at 3 months after operation between two groups(P>0.05). There were no statistical meaning in Maryland items,total score and good rate between two groups at the final following-up(P>0.05).
Conclusion: Artificial bone and autogenous bone in internal fixation of complex calcaneal fracture with irregular plate have similar function in promoting fracture healing,drying time of incision,fracture healing time and complications,while artificial bone has better effects in reducing intraoperative blood loss,shorten operation time. |
| KEYWORDS:Calcaneus Fracture fixation,internal Open fracture reduction 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: | 周梁,褚琪平,俞华军.人工骨和自体骨在复杂跟骨骨折异形钢板内固定术中的病例对照研究[J].中国骨伤,2021,34(9):808~813 |
| 英文格式: | ZHOU Liang,CHU Qi-ping,YU Hua-jun.Case-control study on the application of artificial bone and autogenous bone in internal fixation of complex calcaneal fracture with special-shaped plate[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(9):808~813 |
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