粉碎性跟骨骨折手术治疗57例的的体会.docVIP

粉碎性跟骨骨折手术治疗57例的的体会 　　【摘要】 目的 分析并评价采用切开复位跟骨接骨板内固定方法对粉碎性跟骨骨折的临床疗效。方法 对我院骨科自2008年12月至2010年10月期间收治的57例(71足)跟骨粉碎性骨折患者通过切开复位跟骨接骨板内固定方法实施治疗。结果 本组全部患者进行9个月～3年的随访，平均时间为1?5年，全部57例骨折均愈合，愈合时间平均为2?3个月。其中1例出现切口皮缘坏死，2例出现切口裂开，均通过换药后愈合；2例出现神经损伤，未给予特殊处理。本组患者的足部功能评价根据Maryland Foot Score评分标准，治疗后，28足为优(90~100分)，32足为良(75~89分)，10足为可(61~74分)，1足为差(60分)，优良率达84?5%。结论 切开复位跟骨接骨板内固定对粉碎性跟骨骨折的疗效理想，推荐作为粉碎性跟骨骨折治疗的首选方法。? 　　【关键词】 　　粉碎性跟骨骨折；解剖型钢板；内固定 　　?? 　　Surgical treatment of comminuted calcaneal fracture experience of 57 cases 　　 　　HE Rui.Department of Orthopedics,The Fifth People?s Hospital ofWuhu city in anhui Provine,Wuhu 241000,China 　　? 　　【Abstract】 Objective 　　To analyze and evaluate the use of open reduction and internal fixation of calcaneal plate for comminuted calcaneal fracture efficacy? Methods The hospital orthopedics since December 2008 to October 2010 during the 57 treated patients (71 feet) patients with calcaneal fractures by open reduction and internal fixation of calcaneal plate implementation of treatment? Results All patients 9 months to 3 years of follow?up, the average time of 1?5 years, all 57 fractures healed, the healing time of an average of 2?3 months? Including 1 patient skin flap necrosis, wound dehiscence in 2 cases, were healed by dressing change,2 patients had nerve damage, not given special treatment? The group of patients with foot functional evaluation according to Maryland Foot Score score, after treatment, 28 feet is excellent (90~100 points), 32 feet for good (75~89 points), 10 feet is available (61~74 minutes)， 1 foot for the poor (60 points), good rate of 84?5%?Conclusion Open reduction and internal fixation of calcaneal plate of comminuted calcaneal fractures in the ideal, recommended as the treatment of comminuted calcaneal fractures preferred method.? 　　【Key words】 　　Comminuted calcaneal fracture; anatomic plate;Internal fixation 　　 　　跟骨骨折在全部跗骨骨折病例中占有相当大的比例, 约占60%左右??［1］?。由高处坠落是造成跟骨骨折的最主要原因，因为跟骨具有比较特殊的解剖学结构，其病理解剖较为复杂，骨折发生后其关节面出现塌陷，增加了临床治疗的难