小切口有限内固定联合人工骨植入治疗跟骨关节内骨折.docVIP

小切口有限内固定联合人工骨植入治疗跟骨关节内骨折 　【摘要】 目的 探讨微创小切口有限内固定联合人工骨植入治疗跟骨关节内骨折的疗效。方法 2003年6月—2007年6月作者采用微创小切口有限内固定联合人工骨植入的方法对43例46足跟骨关节内骨折进行治疗，其中男34例37足，女9例9足，术中运用跟骨外侧横行小切口，塌陷的跟骨后关节面复位后选用羟基磷灰石人工骨材料填充跟骨内空腔然后克氏针及螺钉固定。结果 全部患者获得随访，随访12～26个月，46足有2足针道感染，1足切口皮肤表浅坏死，均经换药治愈;按Maryland足部评分系统评价术后功能，本组优29足，良13足，可4足，优良率为91.3%。结论 微创小切口有限内固定联合人工骨植入治疗跟骨关节内骨折具有操作简单，并发症少和临床疗效好等优点。 【关键词】 跟骨;关节内骨折;有限内固定;人工骨植入 　　【Abstract】 Objective To explore the therapeutic effect of treatment of itraarticular fracture of the calcaneus with limited internal fixation with small incision and artificial bone implantation.Methods Fortythree cases of Itraarticular Fracture of the Calcaneus(46 feet) were treated with limited internal fixation with small incision and artificial bone implantation from June 2003 to June 2007.There were 34 male(37 feet) and 9 female(9 feet). Small incision was used extracalcaneus,collapsed facies articularis posterior calcanei after reduction,air containing space of Calcaneus were fiiled with hydroxyapatite ceramic(hac) artificial bone.Results All the cases were followedup from 12 to 26 months.Of the 46 feet,2 cases of pin hole infection and one case of superficial skin necrosis were all cured according to changing dressing.Results were evaluated by Maryland Foot Score, and excellent results occurred in 29, good in 13,fair in 4,the rate of excellent was 91.3%.Conclusion Treatment of itraarticular fracture of the calcaneus with limited internal fixation with small incision and artificial bone implantation is a good meothd because of simple operation,less complications，good clinical effect and so on. 　　【Key words】 calcaneus，itraarticular fracture，limited internal fixation，artificial bone implantation 　　目前切开复位钢板内固定治疗跟骨关节内骨折在临床上已被广泛接受和应用，但由于跟骨外侧软组织覆盖少、血运差等特点，导致术后切口感染、皮缘坏死、钢板外露等并发症问题仍不少见，基于切开复位钢板内固定治疗跟骨关节内骨折带来的诸多问题。本院自2003年6月—2007年6月采用微创小切口有限内固定联合人工骨植入治疗43例46足跟骨关节内骨折，现总结如下。 　　1 资料与方法 　　1.1 一般资料 本组43例46足，其中男34例37足，女9例9足。年龄21～60岁，平均36岁。致伤原因：本组38例系高处坠落伤,5例系车祸伤。骨折按Sander’s分型：Sanders II型2