切开复位钢板内固定治疗跟骨骨折临床疗效分析

Clinical Effect of Open Reduction and Plate Fixation in the Treatment of Calcaneal Fracture

目的分析采用切开复位钢板内固定术治疗跟骨骨折的临床疗效。方法 2009-04～2011-09间,对32例(34足)跟骨骨折患者均采用切开复位钢板内固定手术治疗,骨折均按Sanders分型,其中:Ⅱ型12足,Ⅲ型18足,Ⅳ型4足。手术采用跟骨外侧L形入路。结果 32例患者均获得随访,随访时间8～20个月,平均14个月。术后X线片显示:距下关节、Bohler角、Gissane角接近正常,钢板螺钉无折断,骨折全部愈合,足外观基本正常。4例切口皮缘坏死,经换药后创面愈合,其余病例伤口无感染,无钢板外露;3例出现行走时距下关节疼痛。按Maryland足部评分系统评价治疗效果,其中:优21足,良8足,可4足,差1足,优良率为85.29%。结论切开复位钢板内固定治疗跟骨骨折,能够获得较满意的解剖复位,且固定可靠,是治疗跟骨骨折的有效方法。

Objective To analyze the clinical efficacy of plate fixation in the treatment of calcaneal fractures. Methods From April 2009 to September 2011, 32 cases （34 feet） calcaneal fractures were treated with open reduction and internal fixation surgery. Fractures according to Sanders classification, type Ⅱ 12 feet, 18 feet TypeⅢ, Ⅳ 4 feet. Surgery using the L - shaped lateral calcaneal approach. Results 32 patients were followed - up for 8 -20 months, average 14 months. Post operative X- ray showed that the subtalar joint, Bohler Angle, Gissane Angle are nearly normal, Steel plate screws no broken, all fracture healing, foot appearance basically are normal. According to maryland foot scoring system to evaluate the effect of the treatment, excellent condition for 21 feet, good for 8 feet, 4 feet acceptable, 1 feet unacceptable, Good rate of 85.29%. Conclusion Open reduction and plate fixation could be achieve more satisfactory anatomical reduction, and fixed reliable in calcaneal fracture, it is an effective method for treatment of calcaneal fractures.