摘要
目的研究切开复位内固定治疗跟骨骨折的临床疗效。方法采用回顾性队列研究,选取我院2012年3月-2020年12月行切开复位内固定术并在术后获得完整随访的闭合性跟骨骨折患者49例(51足),按Sanders分型分为三组:Ⅱ型(28例,29足)、Ⅲ型(19例,20足)和Ⅳ型(2例,2足)。比较三组手术中指标、手术前后Bohler角、Gissane角、跟骨长宽高、术后并发症,按照Maryland足部功能评分系统进行术后功能恢复评分。结果三组手术时间、出血量、放置引流数比较,差异无统计学意义(P>0.05),但三组患者植骨数比较,差异具有统计学意义(P<0.05)。SandersⅡ、Ⅲ型患者术前与术后Bohler角、Gissane角、跟骨高度及宽度对比,差异有统计学意义(P<0.05)。三组术后Maryland评分优良率比较,差异无统计学意义(P>0.05)。术后发生并发症共11例,术后切口皮下渗液5例,术后切口部分皮肤坏死1例,5例出现创伤性关节炎。术后切口并发症与是否合并糖尿病、手术时机、手术时长及术后是否引流4个因素存在统计学意义(P<0.05)。SandersⅡ、Ⅲ型术后切口并发症发生率不同(P<0.05)。结论Bohler角、Gissane角与跟骨骨折损伤程度有关。随着跟骨骨折程度的加重,术后足部功能评分相应降低。术后切口并发症与患者是否合并糖尿病、手术时机以及术中是否放置引流可能存在相关性。
Objective To investigate the effect of open reduction and internal fixation for calcaneal fracture.Methods A retrospective cohort study was performed in 49 patients(51 feet)with closed calcaneal fractures who underwent open reduction and internal fixation in our hospital from March 2012 to December 2020 and received complete follow-up after surgery.According to Sanders classification,they were divided into three groups:typeⅡ(28 cases,29 feet),typeⅢ(19 cases,20 feet)and typeⅣ(2 cases,2 feet).The intraoperative indicators,Bohler angle,Gissane angle,calcaneal length,width and height,and postoperative complications were compared between the three groups.The postoperative functional recovery score was evaluated according to the Maryland foot function scoring system.Results There was no significant difference in the operation time,bleeding volume and the number of placed drainage among the three groups(P>0.05),but the difference in the number of bone graft among the three groups was statistically significant(P<0.05).There were statistically significant differences in Bohler angle,Gissane angle,calcaneal height and width between preoperative and postoperative patients with Sanders typeⅡand typeⅢ(P<0.05).There was no significant difference in the excellent and good rate of Maryland score among the three groups(P>0.05).There were 11 cases of postoperative complications,5 cases of postoperative incision subcutaneous effusion,1 case of postoperative incision partial skin necrosis,and 5 cases of traumatic arthritis.Postoperative incision complications were significantly correlated with diabetes,operation time,operation duration and postoperative drainage(P<0.05).The incidence of postoperative incision complications of Sanders typeⅡand typeⅢwas different(P<0.05).Conclusion Bohler angle and Gissane angle are related to the damage degree of calcaneal fractures.With the aggravation of calcaneal fracture,postoperative foot function score decreased accordingly.Postoperative incision complications may be correlated wi
作者
周波
张建
肖颖锋
万圣祥
王全震
ZHOU Bo;ZHANG Jian;XIAO Ying-feng;WAN Sheng-xiang;WANG Quan-zhen(Department of Hand Microsurgery,Shenzhen Hospital of Peking University,Shenzhen 518036,Guangdong,China)
出处
《医学信息》
2021年第23期117-119,共3页
Journal of Medical Information
关键词
跟骨骨折
切开复位内固定术
Sanders分型
Calcaneal fracture
Open reduction and internal fixation
Sanders classification
