Yu Tong-Jun, Zhang Yu-Hang, Wang Lei, Wei Zeng-Bo, Zhao Xi-Bin, Li Ji-Xin
Tianjin Beichen Hospital, Tianjin 300400, China.
Zhongguo Gu Shang. 2021 Sep 25;34(9):801-7. doi: 10.12200/j.issn.1003-0034.2021.09.003.
To compare clinical efficacy between anatomical locking plate (ALP) and ordinary steel plate (OSP) in treating closed calcaneal fractures with SandersⅡ and Ⅲ.
From May 2016 to May 2018, 68 patients with closed Sanders typeⅡ and Ⅲ calcaneal fractures were retrospectively analyzed, and were divided into anatomical locking plate group (ALP group) and ordinary steel plate group (OSP group) according to two kinds of plate fixation, and 34 patients in each group. In ALP group, there were 21 males and 13 females aged from 20 to 63 years old with average of (35.16±8.45) years old; 14 patients were typeⅡand 20 patients were type Ⅲaccording to Sanders classification;treated with ALP. In OSP group, there were 20 males and 14 females aged from 19 to 63 years old with average of (35.05±8.39) years old;19 patients were typeⅡand 15 patients were type Ⅲ according to Sanders classification;treated with OSP. Operative time, intraoperative blood loss and complications between two groups were observed and compared;preoperative and postoperative Böhler angle and gissane angle were also compared;American Orthopaedic Foot & Ankle Society (AOFAS) ankle and hind foot scores, foot and ankle disability index (FADI) scores were applied to evaluate clinical effect.
All patients were followed up from 11 to 14 months with an average of (12.06±0.81) months. There were no statistical differences in opertive time, intraoperative blood loss, incision infection and refracture rate in complications between two groups (>0.05);while there was significant difference in the number of screw loosening (<0.05). Böhler angle and Gissane angle in ALP group at 6 and 12 months after opertaion were higher than that of OSP group (<0.05), and the degree of improvement of Böhler angle and Gissane angle in ALP group were also higher than that of OSP group (<0.05). Postopertaive AOFAS score and FADI score at 6 and 12 months in ALP group were higher than that of OSP group (<0.05), while no statistical difference in AOFAS grading between two groups(>0.05).
Compared with OSP, ALP in treating SandersⅡ and Ⅲ calcaneal fractures could achieve better therapeutic effect, avoid screw loosening, reduce complications, and improve limb function in further.
比较解剖型锁定钢板(ALP)与普通钢板(OSP)治疗SandersⅡ、Ⅲ型闭合性跟骨骨折的临床疗效。
回顾性分析2016年5月至2018年5月68例SandersⅡ、Ⅲ型闭合性跟骨骨折患者,根据两种钢板固定方式分为解剖型锁定钢板组(ALP组)和普通钢板组(OSP组),每组34例。ALP组男21例,女13例,年龄20~63岁,平均(35.16±8.45)岁;按Sanders分型,Ⅱ型14例,Ⅲ型20例;采用ALP治疗。OSP组男20例,女14例,年龄19~63岁,平均(35.05±8.39)岁;按Sanders分型,Ⅱ型19例,Ⅲ型15例;采用OSP治疗。观察比较两组手术时间、术中出血量及并发症;比较术前、术后Böhler角和Gissane角;应用美国足踝外科协会(AOFAS)踝与后足评分、足踝功能障碍指数(FADI)评分评估临床疗效。
所有患者随访11~14个月,平均(12.06±0.81)个月。两组手术时间、术中出血量、切口感染及并发症中再骨折发生率比较,差异无统计学意义(>0.05);而螺钉松动数量差异有统计学意义(<0.05)。ALP组术后6、12个月的Böhler角和Gissane角均高于OSP组(<0.05),且ALP组Böhler角和Gissane角改善程度也高于OSP组(<0.05)。ALP组术后6、12个月的AOFAS评分和FADI评分均高于OSP组(<0.05),而两组AOFAS分级差异无统计学意义(>0.05)。
与OSP相比,ALP治疗SandersⅡ、Ⅲ型跟骨骨折疗效更佳,可避免螺钉松动,减少并发症,进一步改善肢体功能。