锁定接骨板内固定治疗移位的关节内跟骨骨折

Treatment of displaced calcaneus intraarticular fracture with locking plate

目的探讨锁定接骨板内固定治疗移位的关节内跟骨骨折的效果。方法对49例（58足）移位的跟骨关节内骨折（SandersⅡ、Ⅲ、Ⅳ型）采用切开复位锁定接骨板内固定术治疗,术中关节面复位后跟骨外侧放置跟骨锁定接骨板。手术前后测量Bhler角和Gissane角,评价跟骨骨折的复位情况。结果患者均获随访,时间6~28个月。患者切口均无严重感染和广泛的皮肤坏死;骨折均愈合,时间3.5~4.5个月。术后6个月复查X线片显示Bhler角和Gissane角分别为28.3°±6.1°和125.7°±8.5°,与术前比较差异均有统计学意义（P〈0.05）。术后功能按Maryland足部评价系统评分：优40足,良14足,差4足,优良率93.1%。结论切开复位锁定接骨板内固定术治疗移位的关节内跟骨骨折手术方法简单,疗效满意。

Objective To discuss the effect of displaced calcaneus intraarticular fracture treated by open reduction and internal fixation with locking plate. Methods 49 cases（ 58 feet） with displaced calcaneus intraarticular fracture（ Sanders typeⅡ,Ⅲ,Ⅳ） were treated by open reduction and internal fixation with locking plate. After reduction of the calcaneus intraarticular fracture,the locking plate was placed on the lateral calcaneus. The results of reduction were evaluated according to measurement of Bhler angle and Gissane angle after operation. Results All cases were followed up for 6 ~ 28 months. All fractures got union in 3. 5 ~ 4. 5 months with no severe infection and extensive skin necrosis. The Bhler and Gissane angles were restored to 28. 3° ± 6. 1° and 125. 7° ± 8. 5°,and there was statistically significant difference before and after operation respectively（ P〈0. 05）. According to Maryland foot score,the results were excellent in 40 cases,good in 14,and poor in 4,and the total excellent and good rate was 93. 1%. Conclusions The surgical treatment of displaced calcaneus intraarticular fracture with open reduction and locking plate is simple and reliable,the effect is satisfactory.