异型钢板治疗粉碎性跟骨骨折44例分析

Analysis on 44 Cases of Alien Titanium Plate Fixation in the Treatment of Comminuted Calcaneal Fracture

目的探讨应用异型钛钢板内固定治疗粉碎性跟骨骨折的临床疗效。方法对44例手术切开复位加异型钛钢板内固定治疗粉碎性跟骨骨折患者的临床资料进行回顾性分析。均为闭合性骨折,术前行跟骨侧位、轴位X线片及CT检查,骨折多累及距下关节并伴有不同程度移位。手术选择改良Seligson’s切口。结果 44例患者均获随防,时间为6个月～2年。患足切口39例Ⅰ期愈合,2例延迟愈合,3例伤口皮缘坏死(<1cm),经多次换药并辅以红外线理疗后愈合。采用MFS评分标准进行评价,优18例,良22例,可4例,优良率为90.9%。结论跟骨钛钢板内固定治疗跟骨粉碎性骨折可有效恢复跟骨解剖学关系,有利于踝关节早期功能练习,是目前治疗跟骨粉碎性骨折的理想方法。

Objective To study the clinical effect of alien titanium plate fixation in the treatment of eomminuted ealcaneal fracture. Methods 44 cases were retrospectively analyzed, which were surgical open reduction and fixed with shaped titanium plate.They all Were closed fractures. Preoperative lateral line of the calcaneus, axial X-ray and CT examination, multiple fractures involving the subtalar joint, and with varying degrees of displacement. Surgical incision was the improved Seligson＇s. Results 44 patients were followed up, for 6 months to 2 years. Of which 39 patients have a good incision healing,2 cases of delayed healing, and 3 had skin flap necrosis （ 〈 lcm ）, supplemented by repeated dressing changes and healing after infrared therapy. With MFS （ maryland foot score ） score to evaluate： 44 patients in this group in the affected foot, 18 cases were excellent; 22 cases were good; 4 cases were can, good rate was 90.9%. Conclusion By the treatment of alien titanium plate fixation, patients with calcaneal fractures can restore ealcaneal anatomic relations effectively, do functional exercise to ankle early, it was the ideal method for caleaneal fractures.