摘要
背景：SandersⅡ-Ⅲ型跟骨骨折切开复位内固定术后患肢完全负重功能练习的开始时间尚存争议。目的：探讨SandersⅡ-Ⅲ型跟骨骨折切开复位内固定术后患肢完全负重功能练习的开始时间与足部功能的关系。方法方法：选取2010年1月至2013年10月收治的SandersⅡ-Ⅲ型跟骨骨折患者29例36足,按完全负重练习的开始时间分为：A组16例17足,术后6-8周开始部分负重功能锻炼,3个月内开始完全负重锻炼,平均完全负重时间2.8个月;B组13例19足,因个人因素（复合伤、工伤、心理因素等）,术后开始完全负重时间大于3个月,平均完全负重时间5.5个月。结果结果：随访根据Maryland足部评分标准,A组平均为（91.4±3.4）分,B组平均为（86.3±4.5）分,相比较有统计学差异（P〈0.05）。A组切口愈合不良3足,经换药2周愈合;B组切口愈合不良1足,经换药2周愈合,骨髓炎1足,经抗生素骨水泥填充治疗后治愈,两组无明显差别（P〉0.05）。A组平均Bhler角29.5°±3.3°,平均Gissan角130.1°±5.4°,骨折均已愈合;B组平均Bhler角31.1°±2.1°,平均Gissan角131.5°±3.9°,骨折均已愈合。两组统计学无明显差异（P〉0.05）。结论结论：SandersⅡ-Ⅲ型跟骨骨折术后3个月内开始完全负重锻炼患者的足部功能明显优于开始完全负重时间大于3个月的患者。
Background： When to begin full weight-bearing exercise after open reduction and internal fixation for SandersⅡ-Ⅲ calcaneal fractures is still in dispute.Objective： To investigate the relationship between joint function recovery and postoperative full weight-bearing exercise after open reduction and internal fixation for treatment of SandersⅡ-Ⅲ calcaneal fractures.Methods： A total of 29 patients（36 feet） with SandersⅡ-Ⅲ calcaneal fractures treated between January 2010 and October2013 were enrolled in the retrospective study. According to the beginning time of full weight-bearing exercise, the patients were divided into two groups. In group A, 16 patients（17 feet） began partial weight-bearing exercise at 6-8 weeks postoperatively and full weight-bearing exercise within 3 months postoperatively（2.8 months on average）. In group B, 13 patients（19feet） did full weight-bearing exercise with a delay（more than 3 months, 5.5 months on average） after surgery due to personal reasons, such as combined injury, industrial injury and psychological factors.Results： The Maryland foot score was 91.4±3.4 in group A and 86.3±4.5 in group B, and there was significant difference in the Maryland score between groups（P〈0.05）. Three feet in group A and one foot in group B suffered from a poor healing of incision and were cured after dressing change 2 weeks later. Osteomyelitis occurred in one foot in group B and were cured by antibiotic bone cement reconstruction. No significant difference was observed in complications between two groups（P〉0.05）. All fractures were healed. The average Bhler angle and Gissan angle was 29.5°±3.3° and 130.1°±5.4°, respectively,in group A. And in group B was 31.1°±2.1° and 131.5°±3.9°, respectively. There was no significant difference in Bhler angle or Gissan angle between two groups（P〈0.05）.Conclusions： Foot function in the patients who perform full weight-bearing exercise within 3 months postoperatively is superior to those with a delaying full weight-bearing exercise（more than 3 months after surgery）.
出处
《中国骨与关节外科》
2015年第1期62-65,共4页
Chinese Journal of Bone and Joint Surgery
关键词
跟骨骨折
完全负重
锻炼
Calcaneal fracture
Full weight-bearing
Exercise
