跟骨载距突螺钉固定治疗移位性关节内跟骨骨折的疗效

目的 探讨跟骨载距突螺钉固定治疗移位性关节内跟骨骨折的临床疗效。方法 回顾性分析中国科学技术大学附属第一医院2019年1~10月36例跟骨骨折患者的临床资料。根据载距突有无螺钉固定，分为载距突固定组与载距突无固定组，每组18例。比较两组患者术后美国矫形外科足踝学会（AOFAS）评分、贝氏角恢复情况及并发症情况。结果 两组患者均获得半年随访，骨折均获得愈合。载距突固定组患者优良率为94.44%，载距突无固定组优良率为88.89%。两组患者术后贝氏角大小比较，差异有统计学意义（P<0.05）。随时间的推移贝氏角大小有逐渐减小趋势，术前及术后不同时间贝氏角大小差异有统计学意义（P<0.05）。不同手术方式和时间对术后贝氏角大小有交互作用（P<0.05）。载距突固定组患者术后6个月AOFAS评分为（88.92±7.21）分，高于载距突无固定组，差异有统计学意义（P<0.05）。两组患者术前与术后6个月AOFAS评分的差值进行比较，差异有统计学意义（P<0.05）。结论 经载距突置钉可以有效提高术后AOFAS评分，有利于骨折的恢复，降低并发症的发生。

Analysis of curative effect of treatment of displaced intra-articular calcaneal fracture with sustentaculum tali screw fixation

Objective To investigate the clinical effect of sustentacular screw placement in the treatment of displaced intra-articular calcaneal fractures. Methods The clinical data of 36 cases calcaneal fracture from January to October 2019 in the First Affiliated Hospital of University of Science and Technology of China were retrospectively analyzed. According to the sustentaculum tali was fixed with or without screws, the patients were divided into the sustentaculum tali fixed group and the sustentaculum tali non-fixed group, with 18 patients in each group. The postoperative AOFAS score, Baines angle recovery and complications of the two groups were compared. Results All the patients were followed up for half a year and the fractures healed. In fixed group, the good rate was 94.44%. In non-fixed group, the good rate was 88.89%.Comparison of postoperative Bayes angle between the two groups showed statistically significant difference (P<0.05).Over time, the size of Bayes angle tended to decrease, and the difference between preoperative and postoperative time was statistically significant (P<0.05). Different surgical methods and time had an interaction effect on postoperative Bayesangle (P<0.05). In fixed group AOFAS score of 6 months after the operation was (88.92±7.21) points, which was higher than that of non-fixed group, and the difference was statistically significant (P<0.05). The difference in AOFAS score between the two groups before and 6 months after surgery was statistically significant (P<0.05). Conclusion The fixation of sustentacular screw can effectively improve the postoperative AOFAS score, which is conducive to the recovery of fracture and reduce the incidence of complications.