跟骨骨折手术治疗的临床分析

Surgical Trentment of Calcaneal Fracture

目的探讨跟骨关节内骨折内固定治疗的效果。方法自2003年3月-2007年9月,采用切开复位内固定治疗39例44足移位跟骨关节内骨折。据Sander分型,Ⅱ型骨折15足,Ⅲ型19足,Ⅳ型10足,广泛外侧入路,采用钢板内固定治疗,术中侧位X线透视观察Bohler角及Gissane角,Broden位透视观察后关节面恢复情况。结果所有病例随访9～24个月,平均17个月,采用美国Maryland足部评分标准,评价手术效果,其中优26例,良11例,可5例,差2例。结论切开复位钢板内固定治疗跟骨粉碎性骨折,复位较满意,固定可靠,是治疗跟骨关节内骨折的有效方法。

Objective To evaluated the surgical results of open reduction and internal fixation of interarticular calcaneal fractures. Methods From March 2003 to September 2007,44 cases of calcaneal fractures in 39 patients were treated with open reduction. According to Sanders classification, 15 sides were account for type Ⅱ, 19 for type Ⅲ, 10 for type Ⅳ. Extened lateral approach was performed and the fractures were fixed with plate for calcaneus. During operation,lateral roentgenograms were made to assess Bohler angle and Gissane angle. Broden view was made to evaluate congruency of the posterior-facet. Results All the cases were followed up for an average of 17 months（ range 9 to 48 months）. The surgical results were evaluated according to Mary- land Foot Scores, excellent results achieved in 26 cases, good in 11, fair in 5, poor in 2. Conclusion The surgical techniques and results of open reduction and internal fixation of interarticular calcaneal fracture are related to anatomic features of calcaneus and their injury mechanism.