| 章明刚.两种植骨方式在 Sanders Ⅲ、Ⅳ型跟骨骨折手术后的疗效对比研究[J].浙江中西医结合杂志,2020,30(8): |
| 两种植骨方式在 Sanders Ⅲ、Ⅳ型跟骨骨折手术后的疗效对比研究 |
| A comparative study of the effect of two implant methods on Sanders type Ⅲ and Ⅳ calcaneal fractures |
| 投稿时间：2020-01-04 修订日期：2020-02-21 |
| DOI： |
| 中文关键词: 人工骨 自体骨 跟骨骨折 手术 植骨方式 |
| 英文关键词:Artificial bone Autogenous bone Calcaneal fracture Operation Bone grafting |
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| 中文摘要: |
| 目的：比较人工骨和自体骨在复杂跟骨骨折异形钢板内固定术中的应用效果。方法：选取2015年4月～2019年4月本院收治的60例Sanders Ⅲ、Ⅳ型跟骨骨折患者,随机分为人工骨组与自体骨组各30例。2组均采用切开复位锁定钢板内固定术治疗,其中人工骨组骨缺损处植入人工骨,自体骨组骨缺损处植入自体骨。比较手术时间、术中出血量、术后切口干燥时间及愈合时间,并对比术前及术后3个月跟骨结节关节角(B?hler角)及跟骨交叉角(Gissane角)的变化情况,且比较术中、术后并发症发生情况及患足功能恢复情况。结果：人工骨组手术时间明显短于自体骨组(P＜0.05),人工骨组术中出血量明显少于自体骨组(P＜0.05),人工骨组术后切口干燥时间及愈合时间与自体骨组比较无明显差异(P＞0.05)；2组术后3个月的B?hler角及Gissane角均明显大于术前(P＜0.05)),人工骨组后3个月的B?hler角、Gissane角与自体骨组比较均无明显差异(P＞0.05)；人工骨组总并发症发生率与自体骨组比较无明显差异(P＞0.05)；术后均随访4～16个月,末次随访时,两组患足功能恢复优良率比较无明显差异(P＞0.05)。结论：在Sanders Ⅲ、Ⅳ型跟骨骨折锁定发钢板内固定术中,应用人工骨和自体骨在促进骨折恢复方面效果相当,且术后切口干燥时间及愈合时间接近,但使用人工骨可减少减少术中出血量、缩短手术时间,且人工骨的使用并未明显增加并发症的发生。 |
| 英文摘要: |
| Objective: Comparing the application effect of artificial bone and autogenous bone in the internal fixation of complex calcaneal fracture with special-shaped plate. Methods: 60 patients with complex calcaneal fracture admitted to our hospital from April 2015 to April 2019 were selected, who were randomly divided into A group and B group, with 30 cases in each group. The 2 groups were treated with open reduction and internal fixation with special-shaped plate, and the A group was implanted with artificial bone in bone defect, while the B group was implanted with autogenous bone. The operation time, bleeding volume during operation, drying time and healing time of incision after operation were compared, and the changes of calcaneal tubercle articular angle (B?hler angle) and calcaneal cross angle (Gissane angle) before operation and 3 months after operation were compared, and the intraoperative and postoperative complications and functional recovery of affected foot were also compared. Results: The operation time in the A group was significantly shorter than that in the B group (P < 0.05), and the amount of bleeding during operation in the A group was significantly less than that in the B group (P < 0.05), and there was no significant difference in dry time and healing time of incision after operation between A group and B group (P > 0.05). The B?hler angle and Gissane angle at 3 months after operation in the 2 groups were significantly higher than those before operation (P < 0.05), and there was no significant difference in B?hler angle and Gissane angle between the A group and B group at 3 months after operation (P > 0.05). There was no significant difference in the incidence rate of total complications between A group and B group (P > 0.05). All patients were followed up for 4 to 16 months, and there was no significant difference in the excellent and good rate of foot function recovery between the 2 groups at the last follow-up (P > 0.05). Conclusion: In the internal fixation of complex calcaneal fracture with special-shaped plate, artificial bone and autogenous bone have the same effect in promoting the recovery of fracture, and the drying time and healing time of incision after operation are similar, but the use of artificial bone can reduce the amount of bleeding during operation and shorten the operation time, and the occurrence of complications in using artificial bone is not significantly increased. |
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