跟骨关节内骨折的新术式和疗效分析.docVIP

跟骨关节内骨折的新术式及疗效分析 　　作者：李西成,陈占法,焦振清,潘进社,吴希瑞 　　作者单位： 石家庄市，河北医科大学第三医院创伤急救中心 　　【摘要】 目的 探讨切开复位内固定治疗跟骨关节内骨折的新方法及临床疗效。方法 我中心利用微创技术，跟骨外侧小切口，用自行研制的跟骨解剖钢板及螺栓内固定治疗跟骨关节内骨折共150例183侧，单侧117例，双侧33例。术前根据跟骨X线片及CT扫描结果进行分型，其中SandersⅡ型62侧，Ⅲ型87侧，Ⅳ型34侧。结果 术后X线片显示跟骨高度、宽度、长度、以及Bhlers角和Gissanes角均已恢复，无1例切口感染。术后获8～28个月(平均16.3个月)随访。根据美国足踝外科协会跟骨骨折的评分标准：其中优86侧(47.543%)，良81侧(43.72%)，可16侧(8.74%)，优良率为91.3%。结论 微创小切口跟骨解剖钢板螺栓内固定治疗跟骨关节内骨折可获得满意的临床疗效。 　　【关键词】 跟骨;关节内骨折;微创;切开复位;螺栓;内固定 　　Analysis of effect of new procedure on intraarticular fracture of calcaneus LI Xicheng,CHEN Zhanfa, JIAO Zhenqing, et al. The Third Hospital of Hebei Medical University,Shijiazhuang 050051,China 　　【Abstract】 Objective To investigate the effect of surgical operation on intraarticular fracture of calcaneus by new method. Methods Between August 2004 and February 2007, 183 feet in150 patients with calcaneal fracture were treated differently based on the results of Xray and coronal CT scan performed before and after the treatment. The small incision(23 cm) was made at lateral of calcaneus by microinvasive technique,and selfmade calcaneal anatomical plate and screw were used. Based on the results of Xray and coronal CT scan and according to Sanders classification system，there were 62 cases of type Ⅱ, 87 cases of type Ⅲ and 34 cases of type Ⅳ. Results The internal fixation with the calcaneal anatomical plate almost restored the height,length,width, angle of Bhlers and Gissanes of the calcaneus for the 150 patients. None of infection of incision occurred. The results were validated by using Maryland Foot Score. 183 cases of fractures were followed up for 6～36 months (mean 18.3 months) after treatment. Excellent results were noted in 86(47.54%)cases of fractures，good in 81 cases (43.72%)，and fair in 16 cases(8.74%).Conclusion The open reduction with microinvasive and internal fixation with selfmade calcaneal anatomical plate and screw is one of the best ways in the treatment of fracture of calcaneus.