累及距下关节跟骨骨折的手术治疗

Surgical Treatment for Calcaneus Fracture Involving Talocalcaneal Joint

目的 探讨使用开放复位“Y”形钛钢板内固定治疗累及距下关节跟骨骨折的效果。方法 自 1 998年 7月～ 2 0 0 3年 8月 ,使用开放复位“Y”形钛钢板内固定治疗累及距下关节跟骨骨折 1 8例 2 0侧 ,比较手术前后B hler角、Gissane角、跟骨长度、宽度及高度。结果 术后经平均 1 0 6个月随访 ,所有病人均恢复正常行走 ,足弓恢复正常 ,B hler角由术前平均 - 6 2 5°恢复至术后平均 1 9 35°,跟骨丘部高度由术前 36 4 0mm恢复至术后 4 2 90mm。结论 对于累及距下关节跟骨骨折行切开复位“Y”形钛钢板固定 ,即可复位距下关节 ,恢复B hler角、Gissane角 ,同时又可恢复跟骨的长度、高度及宽度 ,使其达到解剖复位 ,病人能早期进行功能锻炼 。

Objective The treatment of open reduction and internal fixation with titanium plate of type “Y” was applied for calcaneus fracture involving talocalcaneal joint.Methods Eighteen patients was performed with this method from July 1998 to August 2003. The Bhler angle, the Gissane angle and length, breadth, height of calcaneus were compared before and after operation.Results The patients were followed up with an average period of 10 6 months. All the patients were healed and their arches became natural. The average data of Bhler angle was 19 35°after operation while -6 25° before operation. The average height of calcaneus was 42 90mm after operation while 36 40mm before operation. Conclusion The treatment of open reduction and internal fixation with titanium plate of type “Y”is a kind of good method for calcaneus fracture involving talocalcaneal joint. It can not only resume the Bhler angle and the Gissane angle, but also resume length, breadth, height of calcaneus. As a result, it can achieve anatomical reduction and patients can do exercises as soon as early.