锁定钢板治疗成人Sanders Ⅲ型跟骨骨折的疗效观察

Effect of Locking Plate in the Treatment of Adult Sanders Type III Calcaneal Fractures

目的：总结锁定钢板治疗成人SandersⅢ型跟骨骨折的手术效果。方法：我院对16例（18足）SandersⅢ型跟骨骨折，采用切开复位锁定钢板内固定术治疗。术后行踝关节功能位石膏固定2周后开始功能锻炼，术后8周开始拄拐行走。结果：所有患者术后随访11～17个月，平均14．8个月。采用Maryland足功能评分系统评价患者术后足部功能。优9例、良8例、可1例，取得满意效果。优良率94％。 Bohler角是由治疗前的5．74±7．03°恢复到治疗后的29．7±3．5°。结论：采用切开复位锁定钢板内固定治疗Sanders Ⅲ型跟骨骨折，术后跟骨Bohler角与Cissane角及足功能恢复良好。切开复位内固定术能更好地恢复Bohler角和Gissane角，骨折愈合及足功能恢复较好，可以做为治疗Sanders Ⅲ型跟骨骨折的首选治疗方法。

Objective：Summarize the effect of locking plate in the treatment of adult Sanders type III calcaneal fractures .Methods：In our hospital, 16 patients （18 feet） Sanders type III calcaneal fractures were treated by open reduction and internal fixation with locking plate.The foot was fixed in plastic cast in an ankle functional position for about 2 weeks postoperatively .Then functional exercise was be-gun.Crutch Crutch walking bega 8 weeks postoperatively .Results：All the patients were followed -up for 11-17 months, average 14.8 months.Evaluation of the postoperative function according to the Maryland foot score showed ,nine feet were excellent ,seven feet were good,two feet were general.Excellent and good rate was 94%.the Bohler angle was recovered from preoperative （5.74 ±7.03）°to postop-erative （29.7 ±3.5）°.Conclusion：Open reduction and internal fixation can better recover the Bohler angle and Gissane angle ,facture healing and functional recovery of the foot are better ,it may be the the first choice of treatment for Sanders type Ⅲcalcaneal fracture .