手术治疗IIIIV型跟骨结节内侧突骨折伍宗芳刘丰潘昊谢鸣作者单位.DOC

手术治疗III、IV型跟骨结节内侧突骨折 伍宗芳 刘丰 潘昊 谢鸣 作者单位：430030武汉，华中科技大学同济医学院附属同济医院（伍宗芳）； 430033武汉，华中科技大学同济医学院附属普爱医院（刘丰 潘昊 谢鸣） 通讯作者：刘丰 sdsgliufeng@ 基金项目：武汉市卫计委课题（WX17C12 自组装多肽KLD-12复合体SDF-1在原位骨组织工程中的应用初探） 【摘要】 目的 探讨手术切开复位内固定治疗III、IV型跟骨结节内侧突骨折的疗效。 方法 2013年1月至2016年1月采用手术治疗III、IV型跟骨结节内侧突骨折患者14例14足，男8例，女6例；年龄19～40岁，平均30.2岁。均采用开放复位固定内侧突骨折，开放或闭合复位固定跟骨关节面骨折。 结果 14例患者术后获10～15个月(平均12个月)随访。所有患者均一期愈合。骨折愈合时间为8～13周(平均10周)。无皮瓣坏死、感染，无骨折不愈合及内固定物松动、断裂等并发症出现。患者术后9～14周(平均12周)可完全负重行走，无明显疼痛不适。末次随访时美国足踝外科协会的AOFAS后足评分为80～96分，平均91分。 结论 经切开复位内固定治疗III、IV型跟骨结节内侧突骨折疗效确切，治疗效果显著。 【关键词】跟骨结节内侧突；骨折；内固定 Abstract Objective: To explore the therapeutic outcomes of open reduction and internal fixation for the III and IV types of medial process of calcaneal tuberosity. Methods From January 2013 to January 2016,14 patients with fracture of the medial process of calcaneal tuberosity at 14 sides were treated by our department. There were 8 males and 6 females, with an average age of 30.2 years(range,19 to 40 years). The surgical methods included open and closed reduction and internal fixation. Results 14 patients were followed up for 12 months (range,10 to 15 months). All patients were primary healing. The bone union time was 10 weeks(range,8 to 13 weeks). Without skin flap necrosis, infection, nonunion of fracture and loosening of internal fixation. Full weight bearing was achieved in a mean time of 12 weeks (range,9 to 14 weeks) with no obvious pain and discomfort. According to the American Orthpaedic Foot an Ankle society ankle hindfoot scale, the mean score was 91(range, 80 to 96) at the follow up. Conclusion The treatment effect of open reduction and internal fixation of type III, IV fracture of the medial calcaneal tuberosity is remarkable. 【Key words】 The medial calcaneal tubercle processes； Fracture； Internal fixation 跟骨骨折为足踝部常见疾病，经跟骨外侧L形切口或跗骨窦切口切开复位跟骨骨折技术已非常成熟 ADDIN EN.CITE ADDIN EN.CITE.DATA [ HYPERLINK \l _ENREF_1 \o Basile, 2016 #55 1]。但临床治疗中往往忽视少数合并跟骨内侧突骨折的病人，此种情况多由于术前对跟骨内侧突骨折认识不够，试图通过单纯外侧切口同时复位内侧突骨折，