CAJ | 학술논문

目的探讨解剖钢板和压力螺栓(Anatomic Plate and CompressionBolts,APCB)治疗跟骨骨性毁损伤的生物力学稳定性的应用效果.方法选取经确诊为跟骨粉碎、关节面显著的碎裂移位、跟骨变宽、高度显著的丢失、Bohler角及Gissane角显著的改变的单侧跟骨关节内严重粉碎骨折的患者102例,随机临床对照试验(randomized controlled trials,RCT)分为两组,观察组应用解剖钢板和加压螺栓治疗,对照组采用经标准的外侧L形切口AO解剖钢板和螺钉治疗.结果观察组的手术时间明显短于对照组(P＜0.05),而Bohler角较对照组改善明显,但两组未发现统计学差异(P＞0.05),手术后负重时间显著地短于对照组(P＜0.05),观察组患者发生术后并发症发生率明显的低于对照组(P＜0.05),而两组患者距下关节炎、AOFAS评分及住院时间均差异无统计学意义(均P＞ 0.05).结论应用小切口微创解剖钢板及加压螺栓进行加压固定、能够减少手术相关并发症,进行早期功能锻炼治疗跟骨骨性毁损伤是一个合理、稳定性较强,能够获得较为理想有效的治疗效果.
목적 탐토해부강판화압력라전(Anatomic Plate and CompressionBolts,APCB)치료근골골성훼손상적생물역학은정성적응용효과.방법 선취경학진위근골분쇄、관절면현저적쇄렬이위、근골변관、고도현저적주실、Bohler각급Gissane각현저적개변적단측근골관절내엄중분쇄골절적환자102례,수궤림상대조시험(randomized controlled trials,RCT)분위량조,관찰조응용해부강판화가압라전치료,대조조채용경표준적외측L형절구AO해부강판화라정치료.결과 관찰조적수술시간명현단우대조조(P＜0.05),이Bohler각교대조조개선명현,단량조미발현통계학차이(P＞0.05),수술후부중시간현저지단우대조조(P＜0.05),관찰조환자발생술후병발증발생솔명현적저우대조조(P＜0.05),이량조환자거하관절염、AOFAS평분급주원시간균차이무통계학의의(균P＞ 0.05).결론 응용소절구미창해부강판급가압라전진행가압고정、능구감소수술상관병발증,진행조기공능단련치료근골골성훼손상시일개합리、은정성교강,능구획득교위이상유효적치료효과.
Objective To investigate the biomechanical stability of anatomic plate and compression bolts (APCB) for calcaneal bone injury.Methods 102 patients diagnosed with calcaneal fracture,obvious fragmentation and shift of articular surface,calcaneal broadening,highly significant loss,and B(O)hler angle and Gissane angle of the unilateral intra-articular calcaneal comminuted fracture were chosen for randomized clinical trial (RCT) and were divided into an observation group and a control group.The observation group were treated with anatomic plate and compression bolts and the control group standard L lateral incision AO anatomic plate and screw.Results The operation time was statistically shorter in the observation group than that in the control group (P＜ 0.05).B(O)hler angle was better in the observation group than in the control group,but with no statistical difference (P ＞ 0.05).After the operation,the weight loading time was significantly shorter and the incidence of complications was lower in the observation group than in the control group (P ＜ 0.05).There were no statistical differences in witharthritis of subtalar joint,AOFAS score,and hospitalization time between these two groups(P ＞ 0.05).Conclusions Small incision minimally invasive anatomic plate and compression bolts for fixation can reduce the incidence of operation-related complications.Early functional exercise in the treatment of calcaneal bone damage is reasonable,strongly stable,can obtain good treatment effect.