跟骨骨折手术疗效分析

Analysis of surgical treatment of calcaneal fractures

目的：探讨跟骨关节内骨折的手术疗效及并发症防治。方法：65例（68足） SandersⅡ、Ⅲ、Ⅳ型跟骨关节内骨折患者行手术内固定治疗。结果：65例均获随访，时间为8～24（18．6±3．3）个月。参考美国足踝外科Maryland足部评分系统评价足部功能：优32例（33足），良26例（28足），可7例（7足）。 SandersⅡ型20例（21足）83～96分，SandersⅢ型37例（39足）76～92分，SandersⅣ型8例（8足）55～69分。术后2例切口感染及时拆线开放引流换药，1个月后愈合而未复发，2例切口皮缘局部缺血性坏死，经过清创后愈合，2例发生腓骨肌腱炎。结论：良好的手术技巧是保证跟骨关节内骨折疗效的关键，正确选择内固定方式，积极预防并发症，能取得满意疗效。

Objective：To evaluate the results of surgical procedure and prevention of the complication of intra -articular calcaneal fractures.Me thods： 65 cases（68 feet）with intra-articular calcaneal fractures which were classified as Sanders type ⅡⅢⅣwere treated by open reduction and internal fixation R. esults：65 cases were followed up for 8--24（18.6 ±3.3）months after operation.According to Maryland foot score system , the results were excellent in 32 cases（33 feet）, good in 26 cases（28feet ）and fair in 7 cases（7 feet）.The scores were restored to 83--96 in 20 cases（21 feet） Sanders type Ⅱ, 76--92 in 37 cases（39 feet） SandersⅢand 55--69 in 8 cases（8 feet） SandersⅣ.2 cases were found incision infection and were healed by drainage and remove the suture in time and were not recurred after 1 month, 2 cases were found necrosis of the wound edge and healed by debridement , peroneal tendonitis happened in 2 ca-ses.Conclusion：Appropriate operative techniques are key points for a successful treatment of intra -articular calcaneal fractures .Good re-sult can be achieved by accurate internal fixations are used and effective measures are taken to prevent the complication .