两种方法治疗跟骨关节内骨折的疗效分析

Efficacy Analysis of Two Methods in the Treatment of Intra - articular Calcaneal Fractures

目的：比较保守治疗与开放复位钢板内固定术治疗跟骨关节内骨折的临床疗效。方法96例（101足）跟骨关节内骨折分成两组，应用保守治疗43例（45足）和应用切开复位内固定治疗53例（56足）。结果96例（101足）随访时间10~41个月，平均随访19.4个月，按 Maryland 足部评分系统评价术后功能，保守治疗组病例总体优良率35.6%，切开复位内固定组病例总体优良率达80.4%。结论切开复位解剖钢板内固定治疗跟骨关节内骨折明显优于保守治疗，是一种较好的方法；切口设计、植骨、准确复位及坚强固定等可以减少并发症的发生。

Objective To compare the effects of operative and conservative treatment of intra - articular calcane-al fractures;To discuss the methods,efficacy and complications of intra - articular calcaneal fractures with anatomic plate internal fixation. Methods 96 patients（101 fractures）with intra - articular calcaneal fractures were divided in-to two groups. 43 cases were treated with nonoperative treatment. 53 cases were treated with open reduction and ana-tomic plate internal fixation. Results Follow - up time was 10 to 41 months with 19. 4 months on average. The total excellent and fine rate in open reduction and calcaneal anatomic plate internal fixation group was 80. 4% with 35. 6%in conservative treatment group evaluated by Maryland foot score. Conclusion Open reduction and anatomic plate in-ternal fixation is better than conservative treatment for intra - articular calcaneal fractures. Serious complications can be minimized by incision design,accurate reduction,bone graft and rigid fixation.