摘要
目的比较微创纵行入路下人字形锁定钢板和解剖型锁定钢板治疗关节内移位跟骨骨折的临床疗效。方法回顾性分析2016年5月—2019年1月武警广东省总队医院收治的57例纵行微创入路治疗关节内移位跟骨骨折患者的临床资料,按内固定钢板的不同,将患者分为A组(人字形锁定钢板组,29例)和B组(解剖型锁定钢板组,28例)。记录手术时间、伤口愈合并发症、住院时间和医疗费用,比较两组术后美国足踝外科学会(AOFAS)踝-后足评分、跟骨高度丢失量及Bohler角、Gissane角的差异。结果术后切口均Ⅰ期愈合。随访时间12~18个月,平均随访时间(15.1±2.0)个月。A组、B组患者的手术时间、住院时间、医疗费用、末次随访跟骨高度丢失量分别为(52.7±5.7)和(62.4±8.5)min、(9.8±2.0)和(11.5±2.6)d、(18177±1411)和(21345±2500)元以及(2.7±1.2)和(1.6±0.9)mm,两组比较,差异均有统计学意义(P<0.05);两组术后AOFAS评分、跟骨Bohler角和Gissane角比较,差异无统计学意义(P>0.05)。结论经微创纵行入路治疗关节内移位的跟骨骨折,应用人字形锁定钢板和解剖型锁定钢板疗效相当,前者手术时间和住院时间短、费用低,后者在维持术后跟骨高度上有一定优势。
Objective To compare the outcome of herringbone locking plate versus anatomic locking plate in the treatment of displaced intra-articular calcaneal fractures via minimally invasive longitudinal approach.Methods Clinical data of a series of 57 patients with displaced intra-articular calcaneal fractures treated by minimally invasive longitudinal approach from May 2016 to January 2019 were retrospectively analyzed.The patients were divided into 2 groups according to different internal fixation plates:group A(29 patients,herringbone locking plate)and group B(28 patients,anatomical locking plate).Operation time,wound healing complications,length of hospital stay and medical expenses were recorded,postoperative changes of American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot score as well as the loss of calcaneal height,Bohler’s and Gissane’s angles were compared between two groups.Results Primary wound healing was found in all patients.Both groups were followed up for 12 to 18 months,with the average of(15.1±2.0)months.The operation time,hospital stay,medical expenses and loss of calcaneal height at the latest follow-up in groups A and B were(52.7±5.7)vs(62.4±8.5)min,(9.8±2.0)vs(11.5±2.6)d,(18177±1411)vs(21345±2500)Chinese yuan,(2.7±1.2)vs(1.6±0.9)mm respectively,which showed statistically differences between two groups(P<0.05).There were no statistical differences in postoperative AOFAS ankle-hindfoot scale score,Bohler’s and Gissane’s angles between two groups(P>0.05).Conclusions For treatment of displaced intra-articular calcaneal fractures,the above two plates via minimally invasive longitudinal approach could obtain similar good effects.Herringbone locking plate could reduce the operation time,hospital stay and hospitalization costs,while anatomic locking plate has certain advantage in maintaining postoperative calcaneal height.
作者
李乔
薛剑
单战
兰天
吴金春
LI Qiao;XUE Jian;SHAN Zhan;LAN Tian;WU Jinchun(Department of Second Surgery,Armed Police Force Guangdong Provincial Corps Hospital,Guangzhou,Guangdong 510000,China)
出处
《中国骨科临床与基础研究杂志》
2020年第4期228-233,共6页
Chinese Orthopaedic Journal of Clinical and Basic Research
关键词
跟骨
骨折
骨折固定术
内
骨板
最小侵入性外科手术
纵行入路
Calcaneus
Fractures
Fracture fixation,internal
Bone plates
Minimally invasive surgical procedures
Longitudinal approach
