解剖型钢板与锁定钢板治疗有移位的跟骨骨折的效果

摘要

目的：对比解剖型钢板和锁定钢板治疗有移位的跟骨骨折的临床疗效。方法选取作者医院骨伤科2011年6月～2013年6月70例因有移位的跟骨骨折（ SandersⅡ～Ⅳ型）患者，随机分为锁定钢板组（n＝35）和解剖钢板组（n＝35）进行内固定治疗。比较两组患者的手术时间和骨折愈合时间，手术前后的Bohler和Gissane角，手术前后的跟骨长度、高度和宽度。术后半年采用Maryland评分标准对跟骨功能进行评价，同时随访半年记录并发症发生情况。结果锁定钢板组的手术时间和骨折愈合时间较解剖钢板组显著缩短（P＜0.01）；两组患者术后1周的Bohler和Gissane角均显著大于术前（P＜0.01）；锁定钢板组术后1周的Bohler和Gissane角均显著大于解剖钢板组（P＜0.01）；两组患者术后1周的跟骨长度、高度均显著大于术前，而跟骨宽度显著小于术前（ P＜0.01）；锁定钢板组术后1周的跟骨长度、高度均显著大于解剖钢板组，而跟骨宽度显著小于解剖钢板组（ P＜0.05）；锁定钢板组的优良率显著高于解剖钢板组，χ2＝4.8837，P＝0.0271＜0.05；两组患者的术后并发症发生率无显著差异（P＞0.05）。结论对于有移位的跟骨骨折，锁定钢板的临床疗效更佳。%Objective To compare the effect of anatomical plate and locking plate for displaced calcaneus fractures.Methods Totally 70 cases of displaced calcaneal fractures (Sanders II-IV type) in our department from Jun.2011 to Jun.2013 were selected and randomly divided into anatomical plate group ( n=35) and locking plate group (n=35).The two groups were compared in operative time and fracture healing time ,Bohler and Gissane an-gle before and after surgery as well as heel length ,height and width of the calcaneus before and after surgery .Mary-land score was adopted to evaluate the function of the calcaneus after six months , and the follow-up complications were recorded.Results The operation time and fracture healing time were significantly shorter in the locking plate group than those in the anatomical plate group (P<0.01).The Bohler and Gissane angle in both groups one week after surgery were significantly greater than those before surgery (P<0.01).Bohler and Gissane angle in the loc-king plate group one week after the surgery were significantly greater than those in the anatomical plate group ( P<0.01 ) .Postoperative heel length and height of the calcaneus in both groups were significantly higher than those be -fore surgery, while the width of the calcaneus was lower (P<0.01).Postoperative heel length and height of the calcaneus in the locking plate group were significantly higher than those in the anatomical plate group , while the width of the calcaneus was lower (P<0.01).The excellent and good rate of locking plate group was significantly higher than that of the anatomical plate group (χ2 =4.8837,P=0.0271<0.05).The incidence of the postopera-tive complications of patients in the two groups had no significant difference ( P>0.05 ) . Conclusion For dis-placed calcaneus fractures ,locking plate has better clinical efficacy .