有限切开复位克氏针内固定治疗跟骨关节内骨折

Treatment to intra - articular calcaneal fractures by limited opening reduction and kirschner wire internal fixation

目的探讨有限切开复位克氏针内固定’冶疗跟骨关节内骨折的临床疗效。方法回顾性分析跟骨关节内骨折26例28足手术治疗情况，年龄19～48岁，平均32．18岁。骨折类型按Sanders跟骨关节内骨折分型：Ⅱ型12足，Ⅲ型12足，Ⅳ型4足。所有骨折采用有限切开复位及多根克氏针固定治疗，观察患者手术情况、并发症、疗效及骨折愈合情况。结果按Maryland足部评分系统评价术后功能：优15足，良9足，中2足，差2足，优良率为85．7％。结论有限切开复位克氏针内固定治疗跟骨关节内骨折具有手术创伤小、出血少、手术合并症少等优点，适合骨折移位较小、Sanders Ⅱ型骨折、多发伤或软组织条件差患者。

Objective To discuss the clinical effect of limited open reduction and kirschner wire intemal fixation to intra - articular calcancal fractures. Methods To retrospectively analyze the surgical treatment of 26 patients with intra - articular caleaneal fracture（28 feet） , with 12 feet of Ⅱ, 12 feet of Ⅲ and 4 feet of Ⅳ according to Sanders classification. All fractures were treated by limited opening and kirschner wire internal fixation. The efficacy and complications of the operation were observed. Results According to Maryland scale system： 15 cases were perfect ,9 cases were good ,2 cases were common and 2 cases were bad. So the rate of excellent and good functional recovery was 85.7%. Conclusion The clinical treatment of Limited Opening reduction（ and Kirschner Wire Internal Fixation） is favorable and has the advantages of less traumas ,less bleeding and less multiple trauma. It fits for the patients who have small displacement fracture or fracture with Sanders Ⅱ or multiple trauma or bad soft tissues.