跟骨骨折手术治疗疗效评定

Effect evaluation of surgical treatment on calcaneal fracture

目的探讨采用切开复位内固定的手术方法治疗跟骨涉及关节面的骨折的疗效。方法随访2006年10月至2010年3月治疗的63例（75足）跟骨涉及关节面的骨折患者，按照Sanders分型：Ⅱ型26足，Ⅲ型35足，Ⅳ型14足。采用切开复位重建型接骨板内固定术，必要时行自体骨或同种异体骨移植治疗。术中G型臂下透视观察Bohler角和Gissane角，Broden位透视观察后关节面的恢复情况。所有患者随访时间为5～31个月，平均18．2个月。结果采用Maryland足部评分标准评价手术效果，优38足，良27足，可9足，差1足，优良率为86．7％。结论切开复位重建型接骨板内固定术治疗跟骨涉及关节面的骨折，能够获得较满意的解剖复位和术后疗效，且固定可靠，是治疗跟骨骨折的有效方法。

Objective To evaluate the surgical techniques and results of open reduction and internal fixation of the intra - articular calcaneal fractures. Methods From October 2006 to March 2010, 75 sides of intra - articular calcaneal fractures in 63 patients were treated with open reduction, most of them supplemented by bone plate fixation of reconstruction, small of them supplemented by autogenous or allogeneic bone grafting. According to Sanders classfieation：26 sides were accounted for type Ⅱ ; 35 for type Ⅲ ; 14 for type Ⅳ. During operation, G - arm roentgenograms were made to assess Btihler angle and Gissane angle, Broden view was made to evaluate congruency of the posterior face. All the cases were followed-up for an average of 18.2 months （ range 5 to 31 months）. Results The clinical results were eval- uated according to Maryland Foot Score, excellent results achieved in 38 cases, good in 27 cases, fair in 9 cases, poor in 1 case, excellent and good rate was 86.7%. Conclusions Open reduction and internal fixation is an effective method for treatment of intra - articular calcaneus fracture.