微创锁定板内固定和切开复位内固定治疗跟骨关节内骨折效果分析

摘要

Objective:To investigate the clinical treatment efficacy of minimally invasive locking plate fixation and open reduction internal fixation in the treatment of intra-articular calcaneal fractures.Method:76 patients with calcaneal fracture in orthopedic department for elective surgery in our hospital from June 2012 to July 2013 were selected.All cases were randomly divided into the minimally invasive fixation group and the open reduction internal fixation group according to the admission number parity,38 cases in each group.The surgical time,intraoperative and postoperative bleeding, hospitalization time,healing time of the two groups were compared.The postoperative treatment efficacies of the two groups were evaluated by AOFAS ankle and hindfoot scoring system,visual analog scale(VAS method)and condensed Health Status Scale(SF-36).Postoperative complications of the two groups were recorded.Result:The surgical time and intraoperative and postoperative bleeding volume of the minimally invasive fixation group were significantly less than the open reduction internal fixation group,the differences were statistically significant(P<0.05).The AOFAS ankle and hindfoot scores and SF-36 scores of the minimally invasive fixation group were significantly higher than the open reduction internal fixation group,the differences were statistically significant(P<0.05).The difference of VAS scores between the two groups was not statistically significant(P>0.05).The total complication rate of the minimally invasive fixation group was 7.9%,it was significantly lower than 36.8% of the open reduction internal fixation group,the difference was statistically significant(P<0.05). Conclusion:The clinical treatment efficacy of intra-articular calcaneal fractures by minimally invasive locking plate fixation is better than open reduction internal fixation.It is helpful to reduce the incidence of postoperative complications,promote functional recovery after calcaneus surgery and improve the quality of life of patients,it is worthy of clinical promotion.%目的：评价微创锁定板内固定和切开复位内固定治疗跟骨关节内骨折临床效果。方法：选取2012年6月-2013年7月在本院骨科择期行手术治疗的76例跟骨骨折患者，按照随机数字表法将其分为微创内固定组和切开内固定组各38例，对两组患者手术时间、术中和术后出血量、住院时间、愈合时间进行比较，利用AOFAS踝和后足评分系统、视觉模拟量表（VAS法）和简明健康状况量表（SF-36）对两组患者术后治疗效果进行评价，并记录两组患者术后并发症发生情况。结果：微创内固定组的手术时间、术中和术后出血量均明显少于切开内固定组，差异均有统计学意义（P<0.05）；微创内固定组患者的AOFAS踝与后足评分和SF-36评分均明显高于切开内固定组，差异均有统计学意义（P<0.05），而两组的VAS评分比较差异无统计学意义（P>0.05）；微创内固定组总并发症发生率7.9%明显低于切口内固定组的36.8%，差异有统计学意义（P<0.05）。结论：微创锁定板内固定治疗跟骨关节内骨折临床效果优于切开复位内固定，有助于减少术后并发症的发生，促进跟骨术后功能恢复，提高患者生活质量，值得在临床推广使用。