跟骨骨折不同治疗方法的临床疗效观察

Clinical Analysis on Different Treatment Methods of Calcaneal Fracture

目的探讨不同治疗方法治疗跟骨骨折的疗效,为临床治疗提供优选方法。方法对2007年2月-2011年9月收治的65例(73足)跟骨骨折患者进行回顾性分析,其中14例采用闭合手法复位石膏外固定(A组),18例采用经皮撬拔复位石膏固定(B组),33例手术切开复位内固定治疗(C组),比较治疗效果并对其进行评估。结果所有患者均获6～22个月随访,平均随访14个月,通过测定治疗前后跟骨高度、宽度、Bhler角及Gissane角进行比较,按AO-FAS评分,A组优良率为64.3%,B组为88.9%,C组为90.9%。结论跟骨骨折临床应采取个性化治疗,关键是尽可能恢复跟距关节面的相适应和跟骨的正常解剖形态,最大限度地恢复足踝关节的功能。

Objective To investigate the results of differences treatment of calcaneal fractures and provide preferred method of treatment. Methods From February 2007 to September 2011,65 cases （73 feet） of calcaneal fractures, 14 cases treated with manual reduction and plaster external fixation （ group A）, 18 cases of percutaneous reduction with cast immobilization （ group B ）, 33 cases of open reduction and internal fixation（ group C） were analyzed retrospectively, the curative effects were assessed. Re- sults All patients were followed up for 6 -22 months （average 14 months）. The calcaneal height and width, B8hler and Gissane angle was determined before and after treatment, according to the AOFAS, excellent and good rate of group A was 64.3% , of group B was 88.9% and of C group was 90.9%. Conclusion The personalized treatment should be taken, the key factors of the treatment are to restore the mutual relation between talus and calcaneus＇ normal anatomy to adapt from the articular surface of the calcaneus ,recover the function of foot and ankle joint as possible.