儿童跟骨骨折内固定的应用

Treatment of children calcaneal fracture with internal fixation

目的 探讨切开复位内固定治疗儿童跟骨骨折疗效及手术适应证.方法 对13例（15足）关节内移位为主的儿童跟骨骨折,行跟骨外侧入路,跟骨骨缺损处采用植骨内固定手术.患者术前摄跟骨侧位、轴位X线片,并行CT三维重建.结果 13例（15足）获得6～18个月随访,术后无切口感染,螺钉断裂等并发症.按照Maryland 评分：优12足,良2足,可1足,优良率93%.术后复查X线片显示Bohler角和Gissane角,均恢复正常.结论 儿童跟骨骨折采用跟骨外侧入路内固定手术,对于骨质缺损严重、关节面塌陷者采用植骨术效果明显.

Objective To study the effect, indication and advantages and disadvantages of open reduction and internal fixation for children calcaneal fracture. Methods With lateral and axial roentgenograph and CT 3-dimensional reconstruction, 13 patients （ 15 feet） with intraarticular displaced calcaneal fractures were treated with internal fixation with bone graft through lateral approach. Results All cases were followed up for 6 ～ 18 months. No wound infection or screw breakage was found. According to Maryland evaluation system, the results were excellent in 12 feet, good in 2 and fair in 1, and the excellent and good rate was 93%. Boehler and Gissane angles were restored in roentgenograph postoperatively. Conclusions It can provide good result in the treatment of children calcaneal fracture with severe bone defect and articular facet collapse by internal fixation through lateral approach.