Sanders Ⅲ、Ⅳ型跟骨骨折的手术治疗

Operative Treatment of Sanders Ⅲ,Ⅳ Type Calcaneal Fracture

目的:探讨手术治疗SandersⅢ、Ⅳ型跟骨骨折的临床疗效。方法:回顾分析2011年6月-2014年6月采用跟骨外侧"L"型切口手术入路、锁定钢板内固定和同种异体骨植骨治疗31例(35足)的严重跟骨骨折。结果:术后出现切口并发症3例,发生率为8.6%;术后跟骨高度、宽度、Bohler角、Gissane角较手术前明显改善(P<0.05)。随访采用Maryland足部评分,优11足、良18足、可5足、差1足,优良率82.9%。结论:跟骨外侧"L"型切口手术入路、锁定钢板内固定和同种异体骨植骨是治疗SandersⅢ、Ⅳ型跟骨骨折的有效方法,术中在复位跟骨后关节面的同时,注意跟骨整个解剖形态的恢复。

Objective： To explore the clinical outcomes of the Sanders Ⅲ, Ⅳ type calcaneal fracture treated by opetating. Methods： 31 cases（35 feet） being severe calcaneal fracture were analyzed retrospetively from Jun 2011 to Jun 2014. These cases were treated by operating with L-shaped lateral approach of calcaneum, fixing with locking plate and grafting with allogeneie bone. Results： There were 3 cases with approach complication after operation and the incidence was 8. 6%. The postoperative outcome of the height, width,Bohler angle ane Gissane angle of calcaneun was more perfectly than the preoperation. Maryland foot score system was using to evaluate the postoperative ruction when the cases were followed up. The results showed 11 excellent, 18 good, 5 fair and 1 poor. The excellent and good rate was 82. 9% Conelusion： It is a effective method to treat the Sanders Ⅲ, Ⅳ type calcaneal fracture with L-shaped lateral approach of ealcaneum, locking plate internal fixation and allogeneic bone graft. It is both importance to recover the posterior talocalcaneal jiont surface and the whole calcaneal anatomic form.