移位跟骨关节内骨折的手术治疗

Displaced intra-articular fractures of the calcaneus treated operatively

目的:探讨应用跟骨钢板治疗跟骨关节内移位骨折的手术技巧和临床疗效。方法:对28例31足有移位的跟骨关节内骨折给予了切开复位,跟骨钢板加植骨的内固定手术治疗。根据Sanders跟骨骨折分型,Ⅱ型骨折14足,Ⅲ型骨折15足,Ⅳ型骨折2足。结果:有28足切口正常愈合,3足切口延迟愈合,无皮肤坏死和感染。患者骨折均正常愈合,所有患者都得到了随访,随访时间为8～16个月,平均12.4个月。术后功能按Maryland足部评分标准进行评分。其中,优15足,良11足,中4足,差1足,优良率84%。结论:切开复位,用跟骨钢板内固定治疗移位的跟骨关节内骨折,可以获得满意的治疗效果。

Objective To investigate the surgical techniques and clinical efficacy of the treatment of displaced intra - articular fractures of the Os Calcis using calcaneal plate. Method Total 28 cases （31 feet） with displaced intra - articular fractures of the ealcaneus were treated surgically with the calcaneal plate and bone graft. According to Sanders classification, 14 feet were classified as type Ⅱ, 15 feet as type Ⅲ and 2 feet as type IV. Results Twenty - eight incisions were healed normally and 3 sustained delayed healing. There were no skin necrosis and infection. All patients had normal unions of the fractures and they had been followed up for an average of 12. 4 months （ ranging from 8 - 16 months）. According to Maryland Foot Score,the result was as follows：IS excellent,ll good,4 fair and 1 poor. The excellent and good rate was 84%. Conclusion Open reduction and internal fixation with calcaneal plate is a good choice for the treatment of displaced intra - articular fractures of the calcaneus.