跟骨骨折的手术治疗

Surgical Treatment of Calcaneal Fracture

目的探讨跟骨关节内骨折内固定手术方法和治疗效果。方法随访2003年3月至2004年10月,采用切开复位“Y”形钢板内固定,必要时行自体骨移植治疗-型跟骨骨折69例共80足。根据Sanders分型,型40足,型28足,型12足。术中侧位X线透视观察Bo。hler角和Gissane角,Broden位透视观察后关节面的恢复情况。所有病例随访时间9-28个月,平均17个月。结果采用Maryland足部评分标准评价手术效果,优38足,良30足,可10足,差2足,优良率85%。结论切开复位钢板内固定治疗跟骨粉碎性骨折,能够获得较满意的解剖复位,且固定可靠,是治疗跟骨粉碎性骨折的有效方法。

Objective To evaluated the surgical techniques and results of open reduction and internal fixation of the inter-articular calcaneal fractures. Methods From March 2003 to October 2004, 80 sides of calcaneal fractures in 69 patients were treated with open reduction and Y-shaped plate fixation through lateral approach, most of them supplemented by autogenous bone grafting. According to Sanders classfication, 40 sides were accouned for type Ⅱ , 28 for type Ⅲ , 12 for type Ⅳ. During operation, lateral roentgenograms were made to assess B61der angle and Gissane angle, Broeden view was made to evaluate congruency of the posterior face. All the cases were followed-up for an average of 17 months（range 9 to 28 months）. Results The clinical results were evaluated according to Maryland Foot Score, excellent results achieved in 38 cases, good in 30, fair in 10, poor in 2, excellent and good rate was 85%. Conclusion The surgical techniques and results of internal fixation to fractures are related to anatomic features of calcaneus and their injury mechanism. It is an effective method of treatment of calcaneus fracture.