三面矫正截骨和距下关节融合治疗跟骨畸形愈合

Treatment of Calcaneal Deformity by Three Facial Correction and Fusion of the Joint

目的：探讨跟骨畸形愈合后手术矫正的方法和疗效。方法：2008年6月—2013年8月,对23例27足畸形愈合的跟骨骨折,采用三面矫正的关节外截骨、原位距下关节融合术进行治疗。结果：23例患者均获得随访,平均时间24个月（18-48个月）。截骨及距下关节融合处12-16周均获得愈合,愈合后无需辅助可自行负重行走,无明显的疼痛不适,无明显的外观畸形,可以穿正常的鞋。按Maryland足部评分标准对23例患者进行术后评分。评分由术前的36.9分（26-51分）,升高到术后的85.6分（77-93分）。结论：对于跟骨高度及长度短缩,有内外翻畸形的跟骨畸形愈合,采用三面矫正的截骨,较好的恢复了跟骨的解剖形态。结合原位距下关节融合术,有效消除了关节炎性症状,获得了满意的疗效。

Objective：To investigate the method and effect of surgical treatment for calcaneal deformity. Methods：23 patients with27 foot deformity fractures from June 2008 to August 2013 were treated by the three surface correction of the joint.Results：All of 23 patients were followed up for an average of 24 months（18-48 months）. Bone cutting and joint fusion at 12-16 weeks were all healed, walking with no support and no obvious painand deformity. Patients can wear normal shoes. 23 patients were treated by Maryland foot score standard. The score was 36.9 points（26-51） and 85.6 points（77-93） after the operation. Conclusion： For the calcaneal height and length of short shrink, there are internal and external deformity of the healing of the fracture and by sing osteotomy of the three sides, a better restoration of the anatomical morphology of the calcaneal can be achieved.This therapy can effectively eliminate the symptoms of arthritis and obtain satisfactory effect.