跟骨关节内骨折的治疗

Treatment of intra-articular calcaneal fractures

目的探讨跟骨关节内骨折的治疗方法及疗效。方法回顾性分析自2003年9月-2006年9月的71例80足跟骨关节内骨折的治疗。根据Sander＇s分型：Ⅰ型18例19足,Ⅱ型25例29足,Ⅲ型20例21足,Ⅳ型8例11足。其中29例32足采用非手术治疗,随访6-36个月,平均12.6个月;另42例48足使用跟骨钢板内固定治疗,术后随访10-36个月,平均16.2个月。结果根据美国足踝骨科协会（AOFAS）评分：靴状支具固定组治疗Sander＇sⅠ型19足,Sander＇sⅡ型13足,优良率分别为94.7%和84.6%;跟骨钢板固定组治疗Sander＇sⅡ型16足、Sander＇sⅢ型21足和Sander＇sⅣ型11足,优良率分别为93.8%、85.7%和81.8%。结论根据Sander＇s分型选择非手术治疗或手术治疗跟骨关节内骨折,疗效满意。

Objective To study the treatment method and the effect of intra-articular calcaneal fractures. Methods From September 2003 to September 2006 in our department, 80 feet of intra-articular calcaneal fractures were treated. According to Sander＇ s classification, there were 19 feet in 18 cases of type Ⅰ , 29 feet in 25 cases of type Ⅱ , 21 feet in 20 cases of type Ⅲ , 11 feet in 8 cases of type Ⅳ. Among them 32 feet of intra-articular calcaneal fractures were treated with external fixation, and 48 feet were treated with open reduction internal fixation and calcaneal plates. Results After the follow-up period from 6 months to 36 months, the data were evaluated with AOFAS scale system. The rates of excellent-good results were 94.7% and 84.6% in group of external fixation including 19 feet of type Ⅰ and 13 feet of type Ⅱ, those were 93.8% ,85.75 and 81.8% in group of calcaneal plates fixation including 16 feet of type Ⅱ , 21 feet of type Ⅲ, 11 feet of type Ⅳ. Conclusion The treatment method of intra-articular calcaneal fractures can be choice to achieve good results according to Sander＇s classification.