切开复位内固定治疗跟骨关节内骨折常见并发症的防治

Prevention and treatment of open reduction and internal fixation for treatment of intra-articular calcaneal fracture complications

目的探讨跟骨关节内骨折行切开复位重建钛板内固定所出现的创伤性关节炎、切缘坏死等常见并发症的防治方法。方法回顾分析2005年3月～2012年11月在我院住院诊治的75例跟骨关节内骨折患者的术前准备、手术治疗、并发症的防治及其预后。结果随访6个月～48个月,平均26个月,按国足踝骨科协会(AOFAS)的后足评分系统进行疗效评定:优31例,良32例,一般10例,差2例,优良率84.0%。结论重建跟骨塌陷的距下关节面及坚强的内固定是预防骨性关节炎的基础,充分的术前准备、风险评估及术后积极应对并发症的防治是关键。

Objective TO investigate the Control methods about Intraarticular calcaneal fractures underwent open reduction and reconstruction plate fixation appears the Common complication,Include traumatic arthritis and cutting edge necrosis.Methods Retrospective analysis Diagnosis and treatment of 75 patients in our hospital patients with intra-articular calcaneal fractures preoperative preparation,surgical treatment,and prevention of complications and their prognosis.Results Followed up for 6 months to 48 years,An average of 26 months.According to the ankle Orthopaedic Society（AOFAS） hindfoot score system efficacy evaluation Excellent in 31 cases,good in 32 cases,generally 10 cases and poor in 2 cases,good rate of 84.0%.Conclusion Subtalar joint surface reconstruction calcaneal collapse and internal fixation is the basis of prevention of osteoarthritis.Adequate preoperative preparation,risk assessment and postoperative actively respond to the prevention and treatment of complications is critical.