可塑性钛钢板治疗跟骨粉碎性骨折的临床体会

The clinical realization of plastic titanic alloy plates in treating on the comminuted fracture of calcaneus

目的探讨跟骨关节内骨折内固定手术方法和治疗效果。方法随访2005年1月至2009年12月,采用切开复位可塑性钛钢板内固定,必要时行人工骨植入治疗SandersⅡ～Ⅳ型跟骨骨折36例共48足。根据Sanders分型,Ⅱ型20足,Ⅲ型15足,Ⅳ型13足。术中侧位X线透视观察Bohler's角和Gissane's角,Bro-den位透视观察后关节面的恢复情况。所有病例随访时间10～16个月,平均12.5个月。结果采用Maryland足部评分标准评价手术效果,优29足,良13足,可4足,差2足,优良率87.5%。结论切开复位可塑性钛钢板内固定治疗跟骨粉碎性骨折,能够获得较满意的解剖复位,且固定可靠,是治疗跟骨粉碎性骨折的有效方法,有临床推广价值。

【Objective】 To evaluated the surgical techniques and results of open reduction and internal fixation of the inter articular calcaneal fractures.【Methods】 From January 2005 to December 2009,48 sides of calcaneal fractures in 36 patients were treated with open reduction and plastic titanic alloy plates fixation through lateral approach,some of them supplemented by artificial bone grafting which accouned for Sanders type Ⅱ~ type Ⅳ.According to Sanders classfication,20 sides were accouned for type Ⅱ,15 for type Ⅲ,13 for type Ⅳ.During operation,lateral roentgenograms were made to assess Bohler′s angle and Gissane′s angle,Broden view was made to evaluate congruency of the posterior face.All the cases were followed-up for an average of 12.5 months（range 10 to 16 months）.【Results】 The clinical results were evaluated according to Maryland Foot Score,excellent results achieved in 29 cases,good in 13,fair in 4,poor in 2,excellent and good rate was 87.5%.【Conclusion】 The surgical techniques and results of internal fixation to fractures are related to anatomic features of calcaneus and their injury mechanism.It is an effective method of treatment of calcaneus fracture and could provide exactly efficiency.