微创内加压治疗跟骨骨折张英泽yingzezhang.pdfVIP

微创内加压治疗跟骨骨折 Calcaneal Fractures Treated by internal compression in a minimally invasive fashion 张英泽 Yingze Zhang 我们针对跟骨关节内骨折诊治的重点和难点，历经10余 年，经系统研究，发表跟骨相关论文60余篇，其中7篇被 SCI收录（JBJS 、Trauma 、Foot Ankle Int等杂志）。我们在 国内外率先提出了： •1. 微创治疗跟骨骨折内加压理论 •2.跟骨骨性毁损伤的概念 We have published more than 60 papers regarding calcaneal fractures. We firstly proposed the internal compression theory, bony destructive injuries of the calcaneus, and the peroneal tenograph classification to describe the compression of peroneus longus and brevistendon sheath 1. 跟骨宽度和高度改变 Changes of Calcaneal Width and Height 压迫腓骨长短肌腱64排 腓骨长短肌腱鞘造影 CT VRT( 容积重建技术) Radiography of Compressing peroneus peroneus longus and longus and brevis tendon brevis peritendineum by 64-slice CT VRT 2. 跟骨内、外翻畸形 Varus and valgus malformation 跟骨骨折伴距跟骨间韧带牵 拉损伤或断裂，如未予修复 重建，影响治疗效果 Calcaneal fracture with talus-calcaneal ligament injury or rupture will affect the outcomes if not be reconstructed. 3. 关节面台阶状移位 Step-shape displacement of articular surface 4. Bohler 角和Gissane 角的改变 The Changes of the Bohler Angle and Gissane Angle 正常 25-40 ° 120-145° Normal Bohler 角 Gissane 角 骨折 Fracture ≈0° 166° Bohler 角是由跟骨后关节面最高点分别做跟骨结节 和前结节最高点连线所形成的夹角，正常25 °-40 ° 术前Bohler 角可以反映跟骨骨折损伤严重程度，术 后Bohler 角可以预测后足功能恢复情况，但是Bohler 角与骨折严重程度以及功能恢复之间均为弱相关 Bohler angle: formed by the intersection of a line drawn from the tuberosity’smost cephalic point to the posterior facet