摘要
目的：研究移位的跟骨关节内骨折的手术治疗方法。方法：移位的跟骨关节内骨折32例35侧，男22例。女10例；平均年龄39．4岁；左侧16例，右侧13例，双侧3例。按Sanders分型法分型，SandersⅢ型21侧，Ⅳ型14侧。对所有病例采用延长的外侧途径应用钢板松质骨螺钉联合固定治疗，钢板为跟骨解剖钢板。结果：32例均获随访，随访时间4—62个月，平均25个月。依据Maryland足部评分评价，优14侧，良8侧，中10侧，差3侧。治疗后并发症主要为伤12裂开并表浅皮肤感染2例，皮肤感染并全层坏死1例，距下关节炎4例，腓骨肌腱炎2例，跟部增宽3例，跟骰关节炎2例。Bohler角与Gissane角术前与术后对比均有显著统计学差异。结论：以延长的外侧途径为入路应用钢板螺钉联合固定治疗移位的跟骨关节内骨折，术后可早期功能锻炼，减少骨折的并发症。
Objective： To study a new kind of operation for displaced intra-articular fractures of the calcaneus. Methods： Of the 32 patients （22 male, 10 female, average age 39.4 years）, there were 35 displaced intra-articular fractures of the calcaneus. Among them, 16 cases were of left foot, 13 cases of right, 3 cases of booth. The fractures were classified according to Sanders classification. Among them, 21 fractures were of type Sanders Ⅲ and 14 of type Sanders IV. All fractures were treated by internal fixation of plate and lag-screw with an extensive lateral approach. The plate was anatomic plate of calcaneus. Results：All the patients were followed up for 4 to 62 months. The average period was 25 months. According to Maryland Foot Score, 14 cases were of the excellent, 8 cases of good, 10 of fair and 3 of bad. The complications included 2 cases of superficial infection, 1 case of deep infection and necrosis, 4 arthritis of the subtalar joint, 2 proneal tendonitis, 2 malaligament of the hindfoot and 3 arthritis of the calcaneocuboid joint. There were significant different meaning of Bohler＇s angle and Gissane＇ s angle between before and after operation. Conclusion： It is an ideal method of treatment of displaced intra-articular fractures of the calcaneus by internal fixation of plate and lag-screw with an extensive lateral approach. The method can make patients early exercise after operation and reduce complication of fracture.
出处
《中国骨伤》
CAS
2007年第5期328-329,共2页
China Journal of Orthopaedics and Traumatology
关键词
跟骨
骨折
骨折固定术
外科手术
Calcaneus
Fractures
Fracture fixation, internal
Surgical procedures,operative
