Comparison between normal anatomic plate and absorbable screw with opening lateral bone flap in treatment of calcaneal fractures of Sanders Ⅱ and Ⅲ
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摘要: 目的 比较"掀开跟骨外侧骨瓣+可吸收钉+加植骨"与"常规外侧切口钢板+植骨"治疗Sanders Ⅱ、Ⅲ型跟骨骨折疗效。 方法 回顾分析宁波市第六医院2011年2月-2014年2月76例Sanders Ⅱ、Ⅲ型跟骨骨折(均为单侧骨折),行"掀开跟骨外侧骨瓣+可吸收钉或+植骨"的40例患者设为A组,行"常规外侧切口钢板+植骨"治疗跟骨骨折的36例患者设为B组。比较2组患者手术时间、术中出血量、术后引流量、并发症发生率、Bohler角、Gissane角、AOFAS (ankle-hindfoot scale)评分、MFS (maryland foot score)评分。 结果 所有患者均获得随访,随访时间为24~36个月(平均28个月)。与B组相比较,A组手术时间更短,术中出血量、术后引流量、术后并发症更少,差异均有统计学意义(均P<0.05);所有患者术后1年、2年Bohler角、Gissane角与术前比较差异均有统计学意义(均P<0.05),A组与B组之间比较差异无统计学意义(P>0.05);2组术后AOFAS评分和MFS评分比较差异无统计学意义(P>0.05)。 结论 应用"掀开跟骨外侧骨瓣+可吸收钉+植骨"治疗Sanders Ⅱ、Ⅲ型跟骨骨折,相对"常规外侧切口钢板+植骨"组手术效果安全可靠,手术时间短,术中创伤小,出血少,术后并发症较少。Abstract: Objective To compare the clinical efficacy between normal anatomic plate + bone graft and absorbable screw + opening lateral bone flap + bone graft in treatment of calcaneal fractures of Sanders Ⅱ and Ⅲ. Methods From February, 2011 to February, 2014, 76 patients of Sanders type Ⅱ and Ⅲ of calcaneal fractures were treated in our department. Forty patients received absorbable screw + opening lateral bone flap + bone graft were assigned into Group A, while 36 patients received normal anatomic plate + bone graft into Group B. The two groups were compared in terms of operation time, bleeding volume, postoperative drainage, postoperative complication, Bohler angle, Gissane angle, Ankle-Hindfoot Scale(AOFAS) and Maryland foot score(MFS). Results The patients were followed up for 24 to 36 months with an average of 28 months. The Group A had less operation time, bleeding volume, postoperative drainage and postoperative complication(P<0.05). There were significant differences in Bohler angle and Gissane angle one year and two year after the operation as compared with those before the operation(P<0.05), but not between the two groups(P>0.05). There were no significant difference in postoperative AOFAS and MFS(P>0.05). Conclusion It is safe and effective to treat calcaneal fractures of Sanders Ⅱ and Ⅲ with absorbable screw + opening lateral bone flap + bone graft. Compared with normal anatomic plate + bone graft, it has less operation time, bleeding volume, operation invasion, postoperative complication.
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Key words:
- Calcaneal fracture /
- Osteotomy /
- Internal fixation /
- Complication
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