两种跟骨关节内骨折治疗方案的临床应用价值比较

目的：比较切开复位内固定、撬拨闭合复位内固定治疗Ⅱ～Ⅲ型跟骨关节内骨折患者的临床疗效情况。方法选择100例跟骨关节内骨折患者，随机分为观察组和对照组各50例。观察组采用经皮撬拔闭合复位内固定术，对照组采用切开复位内固定术，术后随访1年。结果观察组经皮撬拔闭合复位内固定术患者手术时间、切口愈合时间、住院时间均短于对照组；观察组患者术中出血量较对照组少，两组患者比较差异明显。两组患者术后Bohler角、Gissane角测量值结果均较术前明显提高，但差异不明显。结论撬拔闭合复位内固定治疗较切开复位内固定治疗具有手术时间、住院时间、手术创伤小等优点，且术后出现的并发症较少，因此，把握适应症的情况下实行经皮撬拔闭合复位内固定治疗更为有效。

The clinical value of two kinds of treatment for intra-articular calcaneal fractures

Objective To compare clinical therapeutic effects of closed reduction and internal fixation for treating patients with type II to III type of intra‐articular calcaneal fracture .Methods 100 cases of calcaneus joint fracture were randomly divided into observation group and control group two groups ,50 cases in each group .The observation group was treated with percutane‐ous poking reduction scheme of closed reduction and internal fixation ,the control group treated with open reduction and internal fixation treatment scheme .All the patients were followed up after operation ,the follow‐up time was 1 years .Results The oper‐ation time ,incision healing time ,hospitalization time of observation group after the treatment of percutaneous poking closed re‐duction and internal fixation were shorter than the control group ;the operation hemorrhage of observation group was lower than those in the control group .The Bohler angle ,Gissane angle of two groups before surgery significantly improved ,but the differ‐ence wasn't statistically significant .Conclusion The treatment of percutaneous poking reduction scheme of closed reduction and internal fixation had the advantages of shorter operation time ,shorter hospitalization time ,smaller operation trauma than the treatment of open reduction and internal fixation and postoperative complications were less .therefore ,to grasp the indications of the circumstances under which the implementation of percutaneous poking closed reduction and internal fixation treatment is a more effective choice .