可塑性跟骨钛板结合植骨术治疗跟骨骨折的临床分析

目的探讨可塑性跟骨钛板结合植骨术治疗跟骨骨折的临床效果。方法本研究按照随机数字表法将42例跟骨骨折患者随机分为研究组和对照组,其中研究组采用可塑性跟骨钛板结合植骨术治疗,而对照组则仅给予可塑性跟骨钛板治疗,比较两组患者的临床疗效。结果两组患者的手术时间和出血量相比差异无统计学意义(t=1.22、1.57,P﹥均0.05)。两组患者经过积极的治疗后,其中研究组中优10例,良9例,优良率达90.48%(19/21);而对照组中优7例,良6例,优良率为61.90%(13/21);对比两组的优良率可以发现研究组的Maryland足部功能评分优良率明显高于对照组,且差异有统计学意义(χ2=4.73,P﹤0.05)。两组患者手术后Bohler角、Gissane角均得到明显恢复,且差异有统计学意义(t=11.25、10.21,P均﹤0.05);但是研究组的恢复程度明显优于对照组,且差异有统计学意义(t=4.61、5.08,P均﹤0.05)。结论选择适当的手术时机,采用可塑性跟骨钛板结合植骨术治疗跟骨骨折的临床效果佳,能良好的恢复并维持跟骨的Bohler角与Gissane角,能够获得较满意的解剖复位,维持关节面的平整,减轻或避免创伤性关节炎的发生,是治疗跟骨关节内骨折的有效方法。

Clinical analysis of Plastic calcaneus titanium plate combined with bone graft in treatment of calcaneal fractures

OBJECTIVE To explore the plasticity of the calcaneus titanium plate combined with bone graft in treatment of calcaneal fractures.METHODS 42 cases with calcaneal fractures were randomly divided into experimental group and control group according to the random number table,the plastic calcaneus titanium plate combined with bone graft was used in the experimental group,while the control group was given the plasticity calcaneal plate.The clinical efficacy of the two groups were compared.RESULTS There was no significant difference in the operation time and bleeding volume of the two groups(t = 1.22,1.57,P﹥0.05).After active treatment,10 cases showed excellent in,9 cases showed good,and the excellent and good rate was 90.48%(19/21).While the control group was excellent in 7 cases,good in 6 cases,and the excellent and good rate was 61.90%(13/21);Compared with the excellent and good rate of the two groups,the Maryland foot excellent rate of function score was significantly higher than that in control group,and there was significant difference(χ2 = 4.73,P﹤0.05).The Bohler corner and Gissane angle of the two groups after the operation were obviously resumed,and there was significant difference(t = 11.25,10.21,P﹤0.05);but the study group recovery was significantly better than the control group,and there was significant difference(t = 4.61,5.08,P﹤0.05).CONCLUSION Selecting proper operation time,the clinical effect of using plastic calcaneus titanium plate combined with bone graft for calcaneal fracture is good,which could be well restored and maintained the calcaneus Bohler angle and Gissane angle,get the satisfactory anatomic reduction,maintain articular surface,reduce or avoid the occurrence of traumatic osteoarthritis.This method is an effective method for intra-articular calcaneal fractures.