钢板内固定治疗跟骨关节内骨折  

Plate internal fixation in the treatment of intraarticular calcaneal fractures

作　　者：谭祐光 彭继红[1] 黄建凯[1] 余海浪[1] 庹秀均[1] 纪科伟[1] 

机构地区：[1]佛山市南海区第二人民医院骨科,广东佛山528251

出　　处：《临床骨科杂志》2011年第1期62-64,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨钢板内固定治疗跟骨关节内骨折的疗效。方法对23例跟骨关节内骨折患者(26足)采用切开复位钢板内固定,9足行自体髂骨植骨。术前及术后分别摄片观测Bhler角角度及骨折愈合情况,观察并治疗并发症。结果 23例均获随访,时间6～18(10.2±2.4)个月。26足均获得骨性愈合,平均Bhler角由术前的-8.5°～19°(8°±10.4°)恢复到术后的15°～40°(32.6°±7.5°)。采用Maryland足部评分标准评价:优8足,良13足,可4足,差1足。早期并发症:切口皮缘坏死4足,伤口局部积液3足,均经治疗后愈合;无腓肠神经损伤。远期并发症:距下关节创伤性关节炎1例。结论对跟骨关节内骨折只要掌握好合适的手术时机,采用钢板内固定治疗可恢复其正常的力学关系,取得满意的临床疗效。Objective To study the clinical outcome of plate internal fixation in the treatment of intraarticular calcaneal fractures. Methods 23 cases（26 feet）with intraarticular ealeaneal fracture were treated with open reduction and reconstruction plate internal fixation,of which 9 feet were combined with autogenous iliac bone grafting. Bohler＇s angle and the bone healing process were monitored by radiography before and after operation. The postoperative complications were observed and cured. Results 23 cases （ 26 feet ） were followed up 6 - 18 （ 10. 2 - 2.4 ） months. 26 feet were got union. The B0hler＇s angle was recovered from -8. 5° - 19°（8°±10. 4° to 15° -40°（32.6°±7.5°）. Ac- cording to MaiTland score, the results were excellent in 8 feet, good in 13, fair in 4, and poor in 1. The early postoperative complication were 4 cases necrosis of the skin incision margin, and 3 eases of wound drainage,which have been treated and healed. No cases got sural nerve injury. The long term complication was post-traumatic osteoarthritis of posterior subtalar joint in 1 eases. Conclusions In treating ealcaneal fi＇actures with subtalar joint involved,with the suitable timing and plate internal fixation to restore the normal mechanical relation of the calcaneus,the outcome will be satisfied.

关 键 词：跟骨骨折 骨折固定术 内 解剖钢板 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]