异形钛板固定治疗Sanders Ⅱ、Ⅲ型跟骨骨折

Special shaped titanium plate fixation in the treatment of Sanders type Ⅱ,Ⅲ calcaneal fractures

目的：评价异形钛板固定治疗SandersⅡ、Ⅲ型跟骨骨折的临床疗效。方法按Sanders分型，对45例62足Sanders Ⅱ、Ⅲ型跟骨骨折术前进行跟骨侧位、轴位X线摄片及跟骨CT平扫并三维重建，予克氏针撬拨复位，局部植骨，异形钛板做有效固定治疗。随访12～38个月，平均26个月。结果按Maryland足部功能评分，本组62足中，优20足，良38足，可4足，优良率93.5%。结论对移位的跟骨关节内骨折切开复位，植骨重建跟骨形态，行内固定治疗是一种有效的方法，正确把握手术时机及早期功能锻炼可预防和减少骨折并发症的发生。

Objective To evaluate the clinical efficacy of special shaped titanium plate fixation in the treatment of Sanders typeⅡ,Ⅲcalcaneal fractures. Methods According to the Sanders＇ classification system, 45 cases（62 feet） with Sanders type Ⅱ , Ⅲ calcaneal fractures were done preoperative calcaneal lateral, axial X-ray radiography and calcaneal CT scan and three-dimensional reconstruction,and Kirschner repositioning operation, local bone-grafting, and effectively special shaped titanium plate fixation. 45 cases were followed up for 12-38 months, the average was 26 months. Results According to the Maryland foot rating system, there were excellent in 20 feet of 62 feet,good in 38 feet and fair in 4 feet, the excellent and good rate was 93.5%. Conclusion Open reduction for displaced intra-articular calcaneal fractures, bone-grafting to reconstruct the calcaneal shape, fixation is an effective method, correctly grasping the operation time and early functional exercises can prevent and reduce the incidence of fractures complications.