钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折  

Open reduction and internal fixation with plate for Sanders type Ⅱ and type Ⅲ of the calcaneus

作　　者：张俊[1] 厉国定[1] 沈燕国[1] 胡牧[1] 尹伟忠[1] 秦惠敏[1] 胡晓亮[1] 

机构地区：[1]上海市浦东新区人民医院骨科,上海201200

出　　处：《临床骨科杂志》2011年第2期152-154,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折的疗效。方法应用钢板内固定治疗74例（78足）SandersⅡ、Ⅲ型跟骨骨折,均采用跟骨外侧L形切口。测量术前及术后B hler角及Gissane角,按照Mary-land足部评分系统评估疗效。结果 74例均获随访,时间6-24（15.1±5.6）个月。术后B hler角由术前的-23°-30°（12.2°±9.7°）恢复至12°-45°（32.6°±7.0°）,术后Gissane角由术前的83°-139°（113.1°±11.6°）恢复至102°-145°（120.8°±9.6°）。优36足,良34足,可8足,优良率89.7%;Ⅱ型优良率92.3%,Ⅲ型优良率87.2%。3足术后出现伤口浅部皮肤坏死,1足出现伤口深部感染,4足出现腓肠神经损伤症状。结论掌握恰当的手术时机,精细的术中操作,经跟骨外侧L形切口入路、钢板内固定治疗SandersⅡ、Ⅲ型跟骨骨折是一种有效的方法。Objective To evaluate the effects of Sanders type Ⅱ and type Ⅲ of the calcaneus treated with open reduction and internal fixation with plate.Methods 78 calcaneal fractures of Sanders type Ⅱ and type Ⅲ in 74 patients were treated with open reduction and internal fixation with plate through a L-shaped lateral incision.Preoperative and postoperative Bhler angle and Gissane angle were measured and the effects were evaluated according to Maryland foot score system.Results 74 cases were followed up from 6 to 24 months（average 15.1±5.6 months）.The Bhler angle was recovered from-23 °~30°（12.2°±9.7°） to 12 °~45°（32.6°±7.0°） and the Gissane angle was recovered from 83 °~139°（113.1°±11.6°） to 102°~145°（120.8°±9.6°）.36 fractures showed excellent results,34 good,and 8 fair,and the excellent and good rate was 89.7%,92.3% of type Ⅱ and 87.2% of type Ⅲ.3 fractures showed necrosis of superficial part of the incision,1 fracture occurred infection of the deep part and 4 fractures appeared sural nerve injury.Conclusions Open reduction and internal fixation with plate is an effective method to treat Sanders type Ⅱ and type Ⅲ of the calcaneus by grasping correct opportunity of operation and perfect operative technique.

关 键 词：跟骨骨折 骨折固定术 内 钢板 

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