解剖型钛板内固定治疗跟骨关节内骨折临床分析

Clinical analysis of anatomic titanium plate internal fixation in treatment of calcaneus intra-articular fracture

目的:探讨跟骨关节内骨折切开复位+解剖型钛板内固定+架桥式植骨的技巧与疗效。方法:采用解剖型钛板治疗48例共56足SandersⅡ～Ⅳ型跟骨骨折(其中Ⅱ型28足、Ⅲ型21足、Ⅳ型7足),Borden位透视观察后关节面的恢复情况,并测量术前、术后的Bohler′s角、Gissane′s角、Peries′s角的变化。结果:随访时间为6～36个月,术后Bohler′s角、Gissane′s角、Peries′s角明显恢复,术前、术后比较差异有高度统计学意义(P<0.01),术后与健侧比较,差异无统计学意义(P>0.05)。按Maryland足部评分系统,总优良率为83.9%(47/56)。结论:解剖型钛板内固定+架桥式植骨治疗SandersⅡ～Ⅳ型跟骨骨折,固定可靠、并发症少、疗效满意,是治疗跟骨关节内骨折的有效方法。

Objective： To investigate the technique and curative effect of calcaneus intra-articular fracture treated with open reduction anatomic titanium plate internal fixation and bridging bone grafting.Methods： 48 cases（56 feet） sanders type Ⅱ-Ⅳ calcaneus intra-articular fracture（type Ⅱ 28 feet,type Ⅲ 21 feet,type Ⅳ 7 feet） were treated with open reduction anatomic titanium plate internal fixation and bridge bone grafting.The reconstruction of the articular facet was observed by X-ray examination at Borden position post-operatively.Also,the Bohler′s angle,Gissane′s angle and Peries′s angle were measured before and after operation.Results： The cases were followed up for 6 to 36 months.The Bohler′s angle,Gissane′s angle and Peries′s angle were all significantly recovered.The differences were statistically significant when compared with pre-operative data（P〈0.01）,but not statistically significant with the healthy side（P〉0.05）.According to the Maryland evaluation system,the total effective rate was 83.9%（47/56）.Conclusion： It is an effective approach to treat Sanders type Ⅱ-Ⅳ calcaneus intra-articular fracture with anatomic titanium plate internal fixation and bridging bone grafting.The fixation is reliable,with few post-operative complications and promising curative effect. v