可塑性跟骨钛钢板治疗粉碎性跟骨骨折

Effect of titanium plate internal fixation in the treatment of comminuted calcaneal fractures

目的探讨跟骨粉碎性骨折的手术治疗方法与临床疗效。方法对21例（24足）手术治疗的跟骨粉碎性骨折资料进行分析，按Sanders分型，对Ⅱ型、Ⅲ型、Ⅳ型骨折应用一期植骨及可塑性跟骨钛钢板切开复位内固定手术治疗。结果24足跟骨骨折均获得随访，时间9—20个月，平均14个月，所有患者均获得骨性愈合。疗效优14足，良7足，可2足，差1足，优良率87．5％。结论跟骨粉碎性骨折通过手术内固定的方法，可以较好地显露骨折，以利恢复跟骨正常的长度、宽度与高度，恢复正常的Btihler角与Gissane角，可靠地内固定利于术后早期功能锻炼，使足踝关节功能达到最大的恢复。

Objective To evaluate operative methods and the clinical effect for comminuted calcaneal fractures. Methods 21 cases（24 feet） of eomminuted calcaneal fractures were treated by one stage bone grafting plus open reduction and internal fixation with plastic ealcaneus titanium plate. The fractures were classified according to the Sanders system into Sanders II, III and IV subgroups. Results All cases were followed up for 9 - 20 months （ 14 months in average）. All cases recovered with good healing of fracture. According to Maryland score, the results were excellent in 14 feet, good in 7 feet, fair in 2 feet, and poor in 1 foot. The excellent and good rate was 87. 5%. Conclusions By using the method of internal fixation with plastic calcaneus titanium plate,fracture site can be well exposed, which is helpful to recover calcaneus to its normal length, width, height, Gissane angle and Bohler angle. A reliable internal fixation is helpful for early stage functional excise after surgery, which can maximize the recovery of the ankle function.