跟骨骨折3种治疗方法比较

Comparison of three treatments of calcaneus fractures

[目的]探讨跟骨骨折治疗方法.[方法]对123例143足跟骨骨折采用3种不同方法进行治疗.按Sander's分型:Ⅰ型35例38足,Ⅱ型25例26足,Ⅲ型27例35足,Ⅳ型36例44足.随访6个月～8年,平均5.3年.[结果]按Marland足评分评价,石膏固定组Ⅰ型38足,Ⅱ型17足,优良率分别为92.1%、88.2%.骨圆针撬拨固定组Ⅱ型6足,Ⅲ型22足,Ⅳ型31足,优良率分别为83.3%、45.5%、22.6%.跟骨钛钢板内固定组Ⅱ型3足,Ⅲ型13足,Ⅳ型13足,优良率分别为:100%、92.3%、84.6%.[结论]Ⅰ、Ⅱ型骨折石膏固定或骨圆针撬拨固定疗效满意.Ⅲ、Ⅳ骨折骨圆针撬拨固定疗效差.切开复位跟骨钛钢板内固定是治疗跟骨骨折的有效方法.

[ Objective ] To investigate the treatment methods for fracture of calcaneus. [ Method ] Among 123 cases of patients, 143 feet were fractured and treated by using three kinds of methods. According on Sander, S classification, there were 38 feet in 35 cases of type Ⅰ, 26 feet in 25 cases of type Ⅱ, 35 feet in 27 cases of type Ⅲ, and 44 feet in 36 cases of type Ⅳ. The follow-up time was ranged from 6 months to 8 years, with an average of 5.3 years. [ Result] The data were evaluated with Marland Standard. The healing rates were 92.1% and 88.2% in group of plaster fixation（including 38 feet of type Ⅰ and 17 feet of type Ⅱ） ; 88.3%, 45.5% and 22.6% in group of osseous pin pulling-fixation （ including 6 feet of type Ⅱ,22 feet of type Ⅲ and 31 feet of type Ⅳ） ; and 100% , 92.3% and 84.6% in group of Titanium steel internal fixation （including 3 feet of type Ⅱ, 13 feet of type Ⅲ and 13 feet of type Ⅳ）, respectively. [ Conclusion] Both plaster fixation and osseous pin pulling-fixation are accommodated to cure the type Ⅰ and Ⅱ of calcaneus fracture, whereas the osseous pin pulling-fixation is not adapted to those of type Ⅲ and Ⅳ. Titaniun steel internal fixation may he the most effective method for fracture of calcaneus.