解剖型钛钢板治疗跟骨关节内骨折36例

Anatomical titaninum plate fixation in the treatment of intra - articular calcaneal fractures in 36 cases

目的探讨手术治疗跟骨关节内骨折疗效及早期并发症防治方法。方法对36例40足采用切开复位、解剖型钛钢板内固定，自体髂骨植骨25足，同种异体骨植骨6足，人工骨植骨5足，4足未植骨。随访8—32个月，平均18．2个月。结果按Maryland足部评分标准，优23足，良10足，可6足，差1足，优良率为82．5％。出现早期并发症5足，其中切口边缘坏死1足，腓肠神经损伤1足，异体骨植骨切口渗液3足，合并感染1足。结论跟骨关节内骨折选择适当的手术时机，切开复位，注意手术操作，解剖型钛钢板内固定能得到较好的疗效。

Objective To study the effect and early complications of internal fixation for intra - articular calcaneal fractures and their prevention. Methods Forty sides of calcaneal fractures in 36 patients were treated with open reduction and anatomical plate fixation through lateral approach,36 of which were supplemented by bone grafting. All cases were followed up for an average of 18 months（ ranging from 8 to 32 months）. Resuits According to the Maryland foot score system,the results were excellent in 23 cases,good in 10,fair in 6 and poor in 1, and the excellent and good rate was 82.5%. Early complications were found in 5 cases, of which 1 was wound necrosis, 1 sural nerve injury, 3 wound drainage due to xenograft and of which 1 infec tion. Conclusion The anatomical titaninum plate to treat intra - articular fractures of the calcaneus can achieve preferable clinical effects. Serious complications can be minimized in several ways as follows： optimal time for operation and carefully preoperative design considered.