F3微型锁定接骨板治疗跟骨Sanders Ⅱ、Ⅲ型骨折

Application of F3 Fragment Plating System in Management of Sanders Type Ⅱ and Ⅲ Calcaneal Fractures via a Limited Sinus Tarsi Approach

目的探讨经改良跗骨窦切口,使用F3微型锁定接骨板治疗跟骨骨折手术技巧及疗效。方法回顾了2012-03/2013-04月收治40例SandersⅡ、Ⅲ型跟骨骨折(38例患者,男32例,女6例)。其中18例跟骨采用改良跗骨窦切口,F3微型锁定接骨板治疗;另外20例跟骨采用传统经外侧扩大L型切口入路,切开复位锁定跟骨接骨板内固定。术后复查X线,测量Bhler角及Gissane角改善情况,并记录软组织并发症情况。结果微创组17例跟骨获得随访,平均随访时间12.7个月。末次随访时,所有骨折均获得骨性愈合。微创组,Bhler角及Gissane角改善值为(15.39±8.11)°和(8.84±12.24)°,美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)评分84.23±7.97,优良率82.4%。无切口问题发生,1例距下关节创伤性关节炎(5.9%)。结论只要选择合适的病例及合适的骨折类型,经跗骨窦切口有限切开复位F3接骨板技术可以作为治疗跟骨关节内骨折有效方式之一。

Objective To discuss the surgical technique and efficiency of F3 fragment plating system in the management of Sanders typeⅡ and typeⅢ calcaneal fractures via a limited sinus tarsi approach.Methods The materials of40 cases(38 patients,32 males,6 females)with Sanders type Ⅱand type Ⅲ calcaneal fractures between Match 2012 and May 2013 were retrospectively reviewed,18 cases were accepted limited open reducetion with F3 fragment plating system via the sinus tarsi approach.The other 20 cases accepted open reduction and internal fixation with calcaneus locking plate via conventional lateral extensile L-shape approach.X-ray was taken post-operatively,and changes of Bhler angle and Gissane angle were recorded.Wound complications were observed.Results Seventeen cases in minimal invasive group were followed up with 12.7 months in average.Bony union were observed at the final follow-up.The correction of Bhler angle and Gissane angle were(15.39±8.11)°and(8.84±12.24)°in minimal invasive group.The average AOFAS ankle score in the minimal invasive group was 84.23±7.97,and the excellent and good recovery rate was 82.4%.No wound problem,one patient had traumatic arthritis of subtalar joint(5.9%)at final follow-up in the minimal invasive group.Conclusion For the appropriate patients and fracture types,limited open reduction and internal fixation with F3 fragment plating system via a sinus tarsi approach may be a good choice to effectively treat intra-articular calcaneal fracture.