Xu Wen-Bin, Xux Xu Yi-Chun, Yao Hui, Hou Gang, Zhao Hui-Qing, Lyu Lu-Lu
Department of Orthopaedics, the Third Affiliated Hospital of Sun Yat-sen University-Lingnan Hospital, Guangzhou 510000, Guangdong, China.
Department of Orthopaedics, the Third Affiliated Hospital of Sun Yat-sen University-Lingnan Hospital, Guangzhou 510000, Guangdong, China;
Zhongguo Gu Shang. 2018 Jul 25;31(7):594-598. doi: 10.3969/j.issn.1003-0034.2018.07.002.
To compare clinical results of Sanders II-IV fractures of calcaneus treated by self-setting calcium phosphate cement and allograft with locking reconstruction bone plate internal fixation.
From March 2012 to December 2015, 48 patients with Sanders II-IV fractures of calcaneus were treated by open reduction and internal fixation through L-shape incision, bone grafting were performed on reserved bone defect of calcaneal fracture. The patients were divided into self-setting calcium phosphate cement and allograft group according to different materials. Twenty-eight patients in self-setting calcium phosphate cement group, including 23 males and 5 females aged from 22 to 52 years old with an average of (34.46±7.33) years old; 8 cases were type II, 11 cases were type III and 7 cases were type IV according to Sanders classification. Twenty patients in allograft group, including 17 males and 3 females aged from 24 to 55 years old with an average of(36.40±7.93) years old; 6 cases were type II, 7 cases were type III and 9 cases were type IV according to Sanders classification. Postoperative wound complications, Böhler angle before and after operation and 12 months, Maryland functional score were evaluated.
All patients obtained bone union, and were followed up from 12 to 42 months with an average of 25 months. There were no statistical significance in Böhler angle and Manyland score before and after operation and 12 months between two groups. Five patients occurred wound complications in allograft group and 2 cases occurred wound complications in self-setting calcium phosphate cement and allograft group.
Both of open reduction bone grafting and reconstructive plate internal fixation have good effective results for calcaneal fracture. Compared with allograft, self-setting calcium phosphate cement, which has no rejection response and less complications, has equal effects for calcaneal fracture and deserves to be popularized.
比较自固化磷酸钙骨水泥与同种异体骨联合锁定重建钢板内固定治疗跟骨Sanders II-IV型骨折的临床效果。
选取2012年3月至2015年12月间收治的48例跟骨Sanders II-IV型骨折患者,采用L形切口切开复位内固定,对跟骨骨折预留骨缺损处进行植骨。根据植骨材料不同将患者分为自固化磷酸钙骨水泥组和同种异体骨组。自固化磷酸钙骨水泥组28例,男23例,女5例,年龄22~52岁,平均(34.46±7.33)岁;按Sanders分型,II型8例,III型11例,IV型7例。同种异体骨组20例,男17例,女3例,年龄24~55岁,平均(36.40±7.93)岁;按Sanders分型,II型6例,III型7例,IV型9例。评估术后伤口并发症、术前及术后12个月的Böhler角、Maryland功能评分。
所有患者均获得骨性愈合,随访12~42个月,平均25个月。两组术前、术后及术后12个月的Böhler角和Maryland评分比较,差异均无统计学意义。同种异体骨组5例出现伤口并发症,自固化磷酸钙骨水泥与同种异体骨联合组2例出现伤口并发症。
切开复位植骨重建钢板内固定治疗跟骨骨折均有良好疗效。自固化磷酸钙骨水泥与同种异体骨相比,无排斥反应,并发症少,治疗跟骨骨折效果相当,值得推广。