切开复位内固定治疗跟骨关节内骨折

TREATMENT OF CALCANEAL INTERARTICULAR FRACTURE BY OPEN REDUCTION AND INTERNAL FIXATION

目的 探讨切开复位内固定治疗跟骨关节内骨折的临床疗效。方法 跟骨外侧 L 形切口显露跟骨 ,按后关节面和距下关节→ B¨ohler角和 Gissane角→跟骨的长度、宽度和高度的顺序整复跟骨关节内骨折和邻近关节 ;并用可塑型跟骨钛钢板内固定治疗跟骨关节内骨折共 35例 38侧 ,其中 Sander′s 型 8侧 , 型 14侧 , 型 16侧。结果 术后 X线片显示骨折愈合时间为 5～ 12周 (平均 7.1周 ) ;33侧术后获 6～ 2 2个月 (平均 12 .3个月 )随访。按 Maryland足部评分系统评价术后功能 ,其中优 18侧 ,良 13侧 ,可 2侧 ,优良率为 93.9%。结论 切开复位和可塑型跟骨钛钢板内固定治疗跟骨关节内骨折可获得满意的临床疗效。

Objective To investigate the clinical outcome of open reduction and internal fixation of calcaneal interarticular fractures. Methods From August 1998, 38 calcanneal interarticular fractures in 35 cases, including 8 of type Ⅱ, 14 of type Ⅲ and 16 of type Ⅳ according to Sander's classification, were treated by open reduction to restore the posterior articular facet, subtalar facet, Bohler angle and Gissane's angle, following internal fixation by plastic titanic alloy plate. Thirty three calcanneal interarticular fractures were followed up for 6 to 22 months, 12.3 months on average; and the healing time and joint function were evaluated according to Maryland Foot Score System. Results The average healing time of fracture was 7.1 weeks, ranging from 5 to 12 weeks; and the joint function was excellent in 18 calcanneus, good in 13 calcanneus, and the satisfactory rate was 93.9%. Conclusion Open reduction and internal fixation with plastic titanium plate is a good choice for calcaneal interarticular fractures.