摘要
目的探讨跟骨骨折切开复位内固定时，对残留的骨缺损不予植骨的安全性及疗效。方法制备跟骨骨折模型，采用钢板内固定治疗，对残留骨缺损不予植骨，术后进行加载和被动运动试验，测定跟骨的力学性能和几何参数的变化；并对植骨与不植骨进行临床对照研究，比较跟骨参数的变化和功能恢复情况。结果对残留的骨缺损不予植骨，钢板螺钉固定后跟骨的强度和承载能力高于正常跟骨，足弓的稳定性与正常足相当；足踝部被动运动试验前后，跟骨几何参数的差异无统计学意义（P〉0．05）；植骨与未植骨比较，跟骨几何参数的改变、关节面再塌陷的发生率和功能恢复差异均无统计学意义（P〉0．05）。结论只要掌握合理的复位固定方法，对跟骨骨折术中残留的骨缺损不予植骨并不增加骨折再移位和关节面再塌陷的危险，不影响骨折愈合和功能恢复。
Objective To investigate the safety and efficacy of open reduction and internal fixation （ORIF） without bone grafting for displaced intra-articular calcaneal fractures with bone defects. Methods ORIF with screw and plate was applied to calcaneal fracture models. No bone grafting was used to treat the bone defects after reduction. The axial loading test and tendon traction test were applied to measure the mechanical properties and geometric parameters of the calcaneal fracture models. The clinical control trials of the ORIF with and without bone grafting were performed in the treatment of displaced intra-articular calcaneal fractures with bone defects to analyse the differences in calcaneal geometric parameters and functional recovery of foot. Results After ORIF with plate, the strength and bearing capacity of the calcaneal fracture model were higher than those of the normal calcaneus, while the stability of foot arch of the former was similar to that of the latter. There were no significant statistical differences between the ORIF with and without bone grafting in geometric parameters, risk of redisplacement, collapse of the articular surface, and the functional recovery. Conclusion In the treatment of displaced intra-articular calcaneal fractures with bone defects, non-grafting ORIF will not result in an increased risk of fracture redisplacement or the collapse of the articular surface, and will not hinder the healing of fracture or functional recovery, if the fracture has been treated with appropriate reduction and fixation.
出处
《中华创伤骨科杂志》
CAS
CSCD
2007年第11期1015-1019,共5页
Chinese Journal of Orthopaedic Trauma
关键词
跟骨
骨折
骨折固定术
内
骨移植
骨缺损
Calcaneus
Fractures
Fracture fixation, internal
Bone transplantation
Bonedefect
