锁定钢板治疗跟骨关节内粉碎骨折的疗效分析

Open Reduction and Internal Fixation for Severely Displaced Intra-articular Calcaneal Fractures Using Calcaneal Locking Plates

目的评价跟骨锁定钢板治疗跟骨关节内粉碎骨折的疗效。方法 2007年5月至2009年7月,应用跟骨锁定钢板治疗跟骨关节内粉碎骨折32例,男25例,女7例;年龄24～61岁,平均38.5岁。骨折按照Sanders分型,型5例,型19例,型8例。术后随访包括临床检查、X线片及采用Maryland足部评分标准进行足踝功能评分。结果 32例均获随访,时间10～28个月,平均17.2个月。骨折愈合时间9～19周,平均15.4周。无延迟愈合及不愈合,骨折端无移位,内固定无松动、断裂等现象。根据Maryland足部评分标准,优18例,良9例,一般3例,优良率为84.4%。结论跟骨锁定钢板是治疗跟骨关节内粉碎性骨折的有效方法,有利于患肢功能的早日恢复。

Objective To observe the efficacy of using calcaneal locking plates for severely displaced intra-articular calcaneal fractures.Methods From May 2007 to July 2009,32 cases with severely displaced intra-articular calcaneal fractures,including Sanders type Ⅱ 5,type Ⅲ 19,type Ⅳ 8,were treated by open reduction and internal fixation using the calcaneal locking plates.The foot function was evaluated by clinical examination,X-ray,American Orthopedic Foot and Ankle Society（AOFAS） Score and Maryland Foot Score.Results Altogether 32 patients were followed up for 10-28 months（average 17.2 months）.A1l of their fractures healed in a mean time of 15.4（9 to 19）weeks without delayed union,nonunion,displacement,or failure of screws and plates.According to Maryland Foot Score,functional foot sorce was excellent in 18 feet,good in 9 and fair in 3,with excellence rate of 84.4%.Conclusion The calcaneal locking plates can be used to provide stable fixation with a good functional outcome,which is an effective method for the treatment of severely displaced intra-articular calcaneal fractures.