跟骨骨折手术治疗的疗效观察

Effective Observation of Operative Treatment on Calcaneus Fractures

目的观察跟骨骨折的手术治疗效果。方法对54例(58足)跟骨骨折施行切开复位内固定手术。其中SandersⅡ型16例(16足),Ⅲ型28例(30足),Ⅳ型10例(12足)。手术采用跟骨外侧切口,行植骨跟骨钢板螺钉内固定。术后行踝关节功能位石膏固定3～4周后开始功能锻炼。随访5个月～7年,平均44.2个月。结果优40足(占68.97%),良10足(占17.24%),可8足(占13.79%),优良率达86.21%。术前B(?)hler角10.8°,术后28.8°。结论切开复位内固定治疗跟骨骨折复位满意,功能恢复理想,后遗症少。

Objective To observe the result of operative treatment on calcaneus fractures. Methods Fifty-four patients （58 feet） with calcaneus fractures were received open reduction and internal fixation operation in our hospital. Sanders classification included of 16 cases type Ⅱ （16 feet）, 28 cases of type Ⅲ（30 feet）, 10 cases of type Ⅳ （12 feet）.With the lateral approach, the calcaneoastragaloid joint was exposed, collapsed joint surface and the diminished Bohler angle were restored under direct condi- tion. The reduction was maintained temporarily with Kirschner wire. If the reduction of fracture was satisfactory under the image intensifier, then bone graft was finished simultaneously, and the calcaneal plate was instrumented. The foot was fixed in plastic cast in an ankle functional position for about 3 to 4 weeks postoperatively. Then functional exercise was begun, Crutch walking bega 10 weeks postoperatively. Results All the cases were followed up for 44.2 months on average （5 months to 7 years）. Forty feet were excellent （68.97%）, 10 feet were good （17.24%）, 8 feet were general （13.79%）. Excellent and good results accounted for 86.21%. Bohler angle was improved from 10.8° preoperatively to 28.8° postoperatively. Conclusion Open reduction and internal fixation are effective methods in treatment of calcaneus fractures. It earns well reduction, excellent functional restoration, but less sequela.