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非锁定钢板与锁定钢板治疗跟骨关节内骨折的比较。

Comparison of nonlocking plates and locking plates for intraarticular calcaneal fracture.

作者信息

Chen Kangwu, Zhang Hongtao, Wang Genlin, Cheng Yu, Qian Zhonglai, Yang Huilin

机构信息

Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.

Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China

出版信息

Foot Ankle Int. 2014 Dec;35(12):1298-302. doi: 10.1177/1071100714547520. Epub 2014 Aug 14.

Abstract

BACKGROUND

The optimal treatment of displaced intraarticular calcaneal fractures remains challenging. Currently, there is no uniform method to treat such fractures. The purpose of this study was to compare the radiographic and clinical outcome of nonlocking plates and locking plates in the treatment of intraarticular calcaneal fractures.

METHODS

A retrospective comparative study was performed including 42 patients with intraarticular calcaneal fractures that were treated by nonlocking plate (n = 18) or locking plates (n = 24) between January 2010 and June 2012. Radiological and functional outcomes were compared between the 2 groups.

RESULTS

At the final follow-up, all fractures were healed, and the patients with a locking plate had a significantly better Bohler's angle and Gissane's angle compared with the nonlocking plate group (P < .05). No complications occurred for the patients in the locking plate group, and 3 patients in the nonlocking plate group had implant loosening that led to loss of reduction (P < .05). The average American Orthopaedic Foot and Ankle Society hindfoot score in the locking plate group was significantly higher than that in the nonlocking plate group (P < .05). No statistically significant difference between the 2 groups was found regarding SF-36 (P > .05).

CONCLUSION

This study supports the view that locking plates may provide better stability and functional recovery in the treatment of intraarticular calcaneal fractures.

LEVEL OF EVIDENCE

Level III, comparative case series.

摘要

背景

移位的关节内跟骨骨折的最佳治疗方法仍然具有挑战性。目前,尚无统一的方法来治疗此类骨折。本研究的目的是比较非锁定钢板和锁定钢板治疗关节内跟骨骨折的影像学和临床结果。

方法

进行一项回顾性比较研究,纳入2010年1月至2012年6月期间采用非锁定钢板(n = 18)或锁定钢板(n = 24)治疗的42例关节内跟骨骨折患者。比较两组的放射学和功能结果。

结果

在最后随访时,所有骨折均愈合,与非锁定钢板组相比,锁定钢板组患者的Bohler角和Gissane角明显更好(P <.05)。锁定钢板组患者未发生并发症,非锁定钢板组有3例患者出现植入物松动导致复位丢失(P <.05)。锁定钢板组的美国矫形足踝协会后足平均评分明显高于非锁定钢板组(P <.05)。两组在SF-36方面未发现统计学上的显著差异(P>.05)。

结论

本研究支持以下观点,即锁定钢板在治疗关节内跟骨骨折时可能提供更好的稳定性和功能恢复。

证据水平

III级,比较病例系列。

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