小型跟骨钢板的研制及临床应用

Treatment of Intra-articular Calcaneal Fractures Using Mini-Plate Via Small Lateral Approach

目的应用自行设计的小蝶形钛钢板经外侧小切口手术治疗简单的跟骨关节内骨折,探讨其固定效果和疗效。方法对23例27足跟骨关节内骨折,SandersⅡ型13足,Ⅲ型14足,采用小蝶形钢板经外侧有限小切口切开复位内固定治疗,观察跟骨解剖参数和足功能的恢复。结果19例23足获得随访,所有足的外形恢复良好,主要的X线片观察指标得到了有效的恢复,后关节面平整。按Maryland足评分方法评价术后功能,Ⅱ型骨折11足,优8足,良3足;Ⅲ型12足,优6足,良5足,可1足。未发生明显并发症。结论对SandersⅡ和部分Ⅲ型骨折,切开复位小蝶形钛钢板内固定能够取得可靠的固定效果,减小软组织并发症,是一种有效的治疗方法。

Objective To investigate the clinical results of open reduction and internal fixation with butterfly - shape mini - plate via small lateral approach for the relative simple intra - articular calcancal fractures. Methods Twenty three patients with 27 intra- articu- lar calcaneal fractures were treated by open reduction and internal fixation with butterfly - shape mini - plate via small lateral incision. According to Sanders classification, there were 13 type Ⅱ and 14 type Ⅲ calcaneal fractures, The restoration of conference of calcaneus and functional recovery was observed. Results Twenty three feet in 19 patients were followed up. The foot shape of all patients restored to be normal. The conference of calcanues on X ray films was restored effectively. The results were evaluated according to Maryland foot score system. Among the 11 feet of type Ⅱ fractures, 8 were excellent, 3 were good. Of the 12 type Ⅲ fractures, 6 were excellent, 5 good, and 1 fair. No apparent complications occurred. Conclusion Open reduction and internal fixation with butterfly - shape mini - plate via small lateral approach can assure reliable fixation and result in few soft tissue complications, and it is an effective method for Sanders type Ⅱ and some type Ⅲ calcaneal fractures.