文章摘要
张俊杰,赵世波,王宇飞.锁定钢板联合同种异体骨/自体骨移植治疗Sanders Ⅲ、Ⅳ型跟骨骨折.骨科,2019,10(4):325-328
锁定钢板联合同种异体骨/自体骨移植治疗Sanders Ⅲ、Ⅳ型跟骨骨折
Evaluation of locking plates fixation combined with allograft or autologous bone graft in the treatment of Sanders Ⅲ, Ⅳ calcaneal fractures
投稿时间:2018-09-03  
DOI:10.3969/j.issn.1674-8573.2019.04.013
中文关键词: 跟骨骨折  植骨  同种异体骨  自体骨  Sanders分型
英文关键词: Calcaneal fracture  Bone graft  Allograft  Autologous bone  Sanders classification
基金项目:
作者单位E-mail
张俊杰 巩义恒星骨科医院河南巩义 452100  
赵世波 巩义恒星骨科医院河南巩义 452100 52932657@qq.com 
王宇飞 巩义恒星骨科医院河南巩义 452100  
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中文摘要:
      目的 比较锁定钢板内固定联合同种异体骨或自体骨移植治疗Sanders Ⅲ、Ⅳ型跟骨骨折的临床疗效。方法 回顾性分析我院2013年4月至2016年4月采用锁定钢板内固定联合骨移植材料填充治疗的88例单侧Sanders Ⅲ、Ⅳ型跟骨骨折病人的临床资料。43例采用同种异体骨填充(同种异体骨组),45例采用自体骨填充治疗(自体骨组)。比较两组术前、术后12个月跟骨Böhler角、Gissane角,术后完全负重时间,跟骨高度丢失情况以及术后并发症,采用美国足踝外科医师协会(American Orthopedic Foot and Ankle Society, AOFAS)踝与后足功能评分系统评价患足功能。结果 所有病人平均随访12个月,术后12个月两组跟骨Gissane角、Böhler角均较术前恢复,差异有统计学意义(P均<0.05),但两组间的差异无统计学意义(P>0.05);同种异体骨组和自体骨组术后完全负重时间[(6.23±0.83)个月 vs. (5.92±0.83)个月]、患足AOFAS评分[(79.64±14.54)分 vs. (82.21±11.74)分]、跟骨高度丢失量[(2.16±0.39)mm vs. (2.33±0.38)mm]、并发症发生率(23.26% vs. 24.44%)之间的差异均无统计学意义(P均>0.05)。结论 锁定钢板联合同种异体骨或自体骨移植治疗Sanders Ⅲ、Ⅳ型跟骨骨折均能减轻疼痛,纠正跟骨畸形,恢复足功能,疗效无明显差异。
英文摘要:
      Objective To analyze the clinical effects of locking plates fixation combined with allograft or autologous iliac bone graft in the treatment of Sanders Ⅲ, Ⅳ calcaneal fractures. Methods From April 2013 to April 2016, 88 patients with unilateral Sanders Ⅲ, Ⅳ calcaneal fractures were treated by locking plates fixation combined with allograft or autologous iliac bone graft. The patients were divided into allograft group (43 cases) with allograft and autograft group (45 cases) with autologous iliac bone graft. The clinical efficacy was assessed through analyzing the Böhler and Gissane angle restoration before and 12 months post-surgery. The weight bearing time, American Orthopedic Foot and Ankle Society (AOFAS) score and heel height loss of calcaneus at 12th month after operation, and postoperative complications were compared between the two groups. Results All cases were followed up for 12 months. At 12th month after surgery, the Gissane and Böhler angles were significantly improved as compared with those before surgery (both P<0.05), but there was no significant difference between the two groups (P>0.05). There was no significant difference in weight bearing time [(6.23±0.83) vs. (5.92±0.83) months] between the two groups (P>0.05). At 12th month post-surgery, there was no significant difference in AOFAS score (79.64±14.54 vs. 82.21±11.74) and calcaneal height loss [(2.16±0.39) vs. (2.33±0.38) mm] and postoperative complication rate (23.26% vs. 24.44%) between the two groups (all P>0.05). Conclusion The locking plates fixation combined with allograft or autologous iliac bone graft achieved similar clinical effects in the treatment of Sanders Ⅲ and Ⅳ calcaneal fractures with satisfactory effects in relieving the heel pain, correcting heel bone deformity and restoring foot function.
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