撬拨复位治疗跟骨关节内骨折

Allocating Reduction Treatment of Displaced Intra-articuiar Fractures of the Calcaneus

目的:探讨C臂机透视下撬拨复位结合跟骨横径螺旋加压器挤压复位3枚克氏针固定治疗跟骨关节内骨折的疗效。方法:对47例51侧采用本治疗方法的跟骨关节内骨折进行回顾性分析。骨折分型按Paley分型,51侧中48侧获得随访,随访时间3月—24个月。结果:按张铁良足部评分方法评价术后功能,本组治疗优17例,良21例,中7例,差3例,优良率79.17％;PaleyⅡ型、Ⅲ型、Ⅳ型骨折的优良率分别为95.65％、70.58％和50％。结论:撬拨复位结合跟骨横径螺旋加压器挤压复位三枚克氏针固定具有损伤小、不破坏骨折块血供、骨折愈合快的优点。对PaleyⅡ型骨折操作简单疗效满意。

Objective: To discuss the therapeutic effect of allocating reduction combined with screw compressed device to reduce the transverse diameter of calcaneus and fixation with 3 Kinschner wires with the aid of C-arm X-ray device. Methods: Retrospectively analysis 51 calcaneus of 47 cases were treated by this way. According to Paley's classification, followed-up 3-24 months to 48 of 51 calcaneus. Results: According Zhang-tieliang's Foot Scale score to value the post-operative function: 17calcuneus were found excellent and good was 79.12%. The rate of excellent and good of the Paley's Ⅱ type was95.65%, Paley's Ⅲ70.58%, and Paley's IV50%. Conclusion: Allocating reduction combined with screw compressed device to reduce transverse diameter of calcaneus and fixation with 3 Kirschner's wires has following advantages: less injury, affect little in blood supply, quickly fracture union, especially suitable for the fracture of Paley's II type. It's a simple and effective method.