解剖型钢板内固定治疗跟骨关节内骨折

Internal fixation with anatomic plate in treatment of intra - articular calcaneal fractures

目的 评价解剖型钢板治疗跟骨关节内骨折、带骨膜髂骨块重建关节面的的疗效。方法 对37例40侧跟骨关节内骨折患者采用解剖型钢板内固定 对SandersⅡ、Ⅲ型骨折同时行髂骨植骨,Ⅳ型骨折行带髂棘骨膜骨块植骨重建关节面。按Maryland足部评分评价足部功能。结果 28例随访6～48个月,其中优13足(46.4％),良14足(50％),可1足(3.6％),优良率达到96.4％。结论 解剖型钢板能够有效支撑塌陷的跟骨关节面,是一种合理的跟骨骨折内固定器。带骨膜髂骨块植骨修复关节面缺损是一种有效的方法。

Objective To evaluate the effect of internal fixation with anatomic plate in treatment of in-tra-articular calcaneal fractures with different hone grafting methods.Methods 40 fractures in 37 patients with intra-articular calcancai fractures were given internal fixation with anatomic plate.Ilium grafting was done in type II and ID (Sanders' classification) cases,and reconstruction of articular surface using iliac crest with periosteum in type VI cases.The foot functions of the patients were evaluated according to Maryland Foot Scoro.Results In the 28 fractures who were followed up for 6 to 48 months,excellent results were obtained in 13(46.4% ),good in 14 (50% ),fair in 1 (3.6% ),with the excellent and good rate being 96.4%.Conclusion Being able to effectively support the articular surface of calcaneus,the anatomic plate is a fine internal fixation device for calcancai fractures,and grafting using iliac crest with periosteum is an effective method to repair defects of the articular surface.