解剖锁定钢板内固定治疗跟骨骨折的临床研究

目的探讨解剖锁定钢板内固定(anatomical locking plate internal fixation,ALPIF)治疗跟骨骨折(calcaneal fracture,CF)的临床疗效。方法选取2013年1月~2015年12月治疗的CF患者86例,男性58例,女性28例;年龄20~57(38.53±4.28)岁。依照随机数字表法分为ALPIF组(n=44)与传统钢板内固定(ordinary steel plate internal fixation,OSPIF)组(n=42)。ALPIF组行ALPIF治疗,OSPIF组行OSPIF治疗。观察两组手术时间、术后拔管时间、术后拆线时间、负重锻炼时间、骨折愈合时间等手术相关时间指标,术前及术后1年跟骨宽度、跟骨高度、Gissane角、Bohlers角等指标。结果两组手术时间、术后拔管时间、术后拆线时间差异均无统计学意义(P0.05)。ALPIF组术后负重锻炼时间、骨折愈合时间早于OSPIF组,有统计学意义(P0.05)。术后1年,两组跟骨宽度较术前减小,跟骨高度、Gissane角、Bohlers角较术前显著增加,差异有统计学意义(P0.05)。术后1年,ALPIF组跟骨宽度较OSPIF组低,跟骨高度、Gissane角、Bohlers角较OSPIF组高,差异有统计学意义(P0.05)。ALPIF组术后1年优良率(90.91%)高于OSPIF组(73.81%),差异有统计学意义(P0.05)。所有患者均一期愈合,未见骨折不愈合及其他术后并发症发生。结论 ALPIF治疗CF内固定牢靠,术后1年优良率高,值得应用于临床。

Clinical research on anatomical locking plate internal fixation in treating calcaneal fracture

Objective To investigate the clinical efficacy of anatomical locking plate internal fixation( AL-PIF)in the treatment of calcaneal fracture(CF).Methods Totally 86 patients 58 males and 28 females,mean age (38.53 ±4.28)(20-57) years] with CF treated in our hospital from Jan.2013 to Dec.2015 were selected and divided into ALPIF group(n=44) and OSPIF group(n=42) according to the random number table method.ALPIF group was given ALPIF treatment,and ordinary steel plate internal fixation( OSPIF) group was given OSPIF treat-ment.The operation time,postoperative extubation time,postoperative stitches removal time,loading exercise time, fracture healing time and other operation relevant time indicators of the two groups were observed.Besides,the width and height of calcaneus,the Gissane angle,the Bohlers angle and the clinical efficacy of the two groups before opera-tion and at 1 year after operation were observed.Results The differences in operation time,postoperative extuba-tion time,postoperative stitches removal time,postoperative loading exercise time,indicators of the two groups had no statistical significance(P>0.05).The postoperative loaded exercise time and fracture healing time of the ALPIF group were shorter than those of the OSPIF group,and the differences were statistically significant(P<0.05).One year after the operation,the widths of calcaneus of the two groups were smaller than those before operation,while the heights of calcaneus,Gissane angles and Bohlers angles were significantly larger than those before operation,and the differences were statistically significant(P<0.05).One year after operation,the width of calcaneus of the ALPIF group was smaller than that of the OSPIF group,the height of calcaneus,the Gissane angle and Bohlers angle were larger than those of the OSPIF group,and the differences were statistically significant(P<0.05).The excellent and good rate of the ALPIF group ( 90.91%) one year after operation was higher than that of the OSPIF group (73.81%),and the difference was statistically significant(P<0.05).All of the patients were healed by first inten-tion,and no ununion or other postoperative complications was found.Conclusion ALPIF in the treatment of CF has firm fixation,and the excellent and good rate at one year after operation is high.The therapy is worthy of clinical application.